NPI 1174338552

Jesubielin Custodio Peronilla, PT

Practitioner Physical Medicine & Rehabilitation Physician Astoria, NY

Practice location

Address: 3808 23rd Ave APT 1f, Astoria, NY 11105-1963
Phone: (347) 350-1235

Registered specialties

Physical Medicine & Rehabilitation Physician Primary

Allopathic & Osteopathic Physicians Taxonomy 208100000X Licence 050395 (NY)

Other Physical Medicine & Rehabilitation providers in New York →

Registry record

NPI: 1174338552
Entity type: Individual
Sex (as registered): Male
NPI issued: 11 Feb 2025
Record last updated: 11 Feb 2025

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.