Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 225100000X | Physical Therapist | 015652-1 | NY |
N | 2251G0304X | Physical Therapist - Geriatrics | 015652-1 | NY |
N | 2251P0200X | Physical Therapist - Pediatrics | 015652-1 | NY |
NPI | 1043288236 |
---|---|
Provider Name | John Patrick Santos |
First Address | Staten Island, NY 10307-1166 |
Second Address | Staten Island, NY 10307-1166 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/03/2006 |
Last Update Date | 08/07/2007 |