Basic Information
| Provider Information | |||||||||
| NPI: | 1710528443 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | CALAYCAY | ||||||||
| FirstName: | JOANA MARI | ||||||||
| MiddleName: | SILVERIO | ||||||||
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| Credential: | PT | ||||||||
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| Mailing Information | |||||||||
| Address1: | 872 47TH ST | ||||||||
| Address2: | |||||||||
| City: | BROOKLYN | ||||||||
| State: | NY | ||||||||
| PostalCode: | 112202325 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9292576161 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1312 38TH ST | ||||||||
| Address2: | |||||||||
| City: | BROOKLYN | ||||||||
| State: | NY | ||||||||
| PostalCode: | 112183612 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7186863700 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 10/03/2019 | ||||||||
| LastUpdateDate: | 10/03/2019 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208100000X | 040968 | NY | Y | Allopathic & Osteopathic Physicians | Physical Medicine & Rehabilitation |
ID Information
| ID | Type | State | Issuer | Description | 040968 | 01 | NY | PROFESSIONAL LICENSE | OTHER |