Provider Demographics
NPI:1093172397
Name:SANTA MARIA, MARIA
Entity Type:Individual
Prefix:
First Name:MARIA
Middle Name:
Last Name:SANTA MARIA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1676 SUNSET AVE
Mailing Address - Street 2:PHYSICAL & OCUPATIONAL THERAPY UNIT
Mailing Address - City:UTICA
Mailing Address - State:NY
Mailing Address - Zip Code:13502-5416
Mailing Address - Country:US
Mailing Address - Phone:315-624-5400
Mailing Address - Fax:315-624-5395
Practice Address - Street 1:1676 SUNSET AVE
Practice Address - Street 2:PHYSICAL & OCUPATIONAL THERAPY UNIT
Practice Address - City:UTICA
Practice Address - State:NY
Practice Address - Zip Code:13502-5416
Practice Address - Country:US
Practice Address - Phone:315-624-5400
Practice Address - Fax:315-624-5395
Is Sole Proprietor?:No
Enumeration Date:2016-01-19
Last Update Date:2016-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY024713225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist