Provider Demographics
NPI:1750422887
Name:CUETO, CELSO CABILES (PT)
Entity type:Individual
Prefix:
First Name:CELSO
Middle Name:CABILES
Last Name:CUETO
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:360A W MERRICK RD
Mailing Address - Street 2:SUITE # 280
Mailing Address - City:VALLEY STREAM
Mailing Address - State:NY
Mailing Address - Zip Code:11580-5344
Mailing Address - Country:US
Mailing Address - Phone:516-837-3457
Mailing Address - Fax:516-776-9695
Practice Address - Street 1:360A W MERRICK RD
Practice Address - Street 2:SUITE # 280
Practice Address - City:VALLEY STREAM
Practice Address - State:NY
Practice Address - Zip Code:11580-5344
Practice Address - Country:US
Practice Address - Phone:516-837-3457
Practice Address - Fax:516-776-9695
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-10
Last Update Date:2009-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY019423-1225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist