Provider Demographics
NPI:1265325344
Name:ABABA, GILBERT RODRIGUEZ (PTA)
Entity type:Individual
Prefix:
First Name:GILBERT
Middle Name:RODRIGUEZ
Last Name:ABABA
Suffix:
Gender:M
Credentials:PTA
Other - Prefix:
Other - First Name:GILBERT
Other - Middle Name:RODRIGUEZ
Other - Last Name:ABABA
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PTA
Mailing Address - Street 1:15 CHESTER DR
Mailing Address - Street 2:
Mailing Address - City:YONKERS
Mailing Address - State:NY
Mailing Address - Zip Code:10710-2101
Mailing Address - Country:US
Mailing Address - Phone:914-434-4018
Mailing Address - Fax:
Practice Address - Street 1:15 CHESTER DR
Practice Address - Street 2:
Practice Address - City:YONKERS
Practice Address - State:NY
Practice Address - Zip Code:10710-2101
Practice Address - Country:US
Practice Address - Phone:914-309-5066
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-05-29
Last Update Date:2025-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY007984225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant