Provider Demographics
NPI:1023374865
Name:PRESTON, SANDI (PT)
Entity Type:Individual
Prefix:
First Name:SANDI
Middle Name:
Last Name:PRESTON
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1696 COUNTY HIGHWAY 50
Mailing Address - Street 2:
Mailing Address - City:CHERRY VALLEY
Mailing Address - State:NY
Mailing Address - Zip Code:13320-2610
Mailing Address - Country:US
Mailing Address - Phone:315-985-1321
Mailing Address - Fax:
Practice Address - Street 1:1696 COUNTY HIGHWAY 50
Practice Address - Street 2:
Practice Address - City:CHERRY VALLEY
Practice Address - State:NY
Practice Address - Zip Code:13320-2610
Practice Address - Country:US
Practice Address - Phone:315-985-1321
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-04-05
Last Update Date:2012-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY008048225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist