Provider Demographics
NPI:1760105803
Name:PABELLANO, JANICE GULLAS (PT, DPT, GCS)
Entity type:Individual
Prefix:
First Name:JANICE
Middle Name:GULLAS
Last Name:PABELLANO
Suffix:
Gender:F
Credentials:PT, DPT, GCS
Other - Prefix:
Other - First Name:JANICE
Other - Middle Name:
Other - Last Name:PABELLANO
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PT, DPT, GCS
Mailing Address - Street 1:1600 N SYCAMORE AVE APT 209
Mailing Address - Street 2:
Mailing Address - City:ROSWELL
Mailing Address - State:NM
Mailing Address - Zip Code:88201-8823
Mailing Address - Country:US
Mailing Address - Phone:704-691-9773
Mailing Address - Fax:
Practice Address - Street 1:400 N PENNSYLVANIA AVE UNIT 101
Practice Address - Street 2:
Practice Address - City:ROSWELL
Practice Address - State:NM
Practice Address - Zip Code:88201-4754
Practice Address - Country:US
Practice Address - Phone:575-623-9101
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-09-23
Last Update Date:2025-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV003939225100000X
WVGE2102582251G0304X
NMPT-2025-0171225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No2251G0304XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGeriatrics