Provider Demographics
NPI:1649658022
Name:FILOMENO, JAVE GARCES (RPT)
Entity type:Individual
Prefix:MISS
First Name:JAVE
Middle Name:GARCES
Last Name:FILOMENO
Suffix:
Gender:F
Credentials:RPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:440 MERIDEN RD
Mailing Address - Street 2:APT 411
Mailing Address - City:WATERBURY
Mailing Address - State:CT
Mailing Address - Zip Code:06705-2220
Mailing Address - Country:US
Mailing Address - Phone:432-517-5710
Mailing Address - Fax:
Practice Address - Street 1:440 MERIDEN RD
Practice Address - Street 2:APT 411
Practice Address - City:WATERBURY
Practice Address - State:CT
Practice Address - Zip Code:06705-2220
Practice Address - Country:US
Practice Address - Phone:432-517-5710
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-05-18
Last Update Date:2015-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT009369225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist