Provider Demographics
NPI:1174687719
Name:SARMIENTO, RICHARD MARK (PT)
Entity Type:Individual
Prefix:MR
First Name:RICHARD
Middle Name:MARK
Last Name:SARMIENTO
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
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Mailing Address - Street 1:2130 VAUXHALL RD
Mailing Address - Street 2:
Mailing Address - City:UNION
Mailing Address - State:NJ
Mailing Address - Zip Code:07083-5875
Mailing Address - Country:US
Mailing Address - Phone:212-810-9347
Mailing Address - Fax:347-438-3362
Practice Address - Street 1:12 W 21ST ST
Practice Address - Street 2:2ND FLOOR
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10010-6902
Practice Address - Country:US
Practice Address - Phone:646-484-5763
Practice Address - Fax:347-287-6873
Is Sole Proprietor?:No
Enumeration Date:2006-12-20
Last Update Date:2013-08-21
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY022608-1225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist