Provider Demographics
NPI:1205418688
Name:VSANTAMARIA PHYSICAL THERAPY
Entity Type:Organization
Organization Name:VSANTAMARIA PHYSICAL THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COMPANY PRESIDENT & PT PROVIDER
Authorized Official - Prefix:DR
Authorized Official - First Name:VICTOR
Authorized Official - Middle Name:FRANCISCO
Authorized Official - Last Name:SANTAMARIA GONZALEZ
Authorized Official - Suffix:
Authorized Official - Credentials:PT, MS, PHD
Authorized Official - Phone:541-974-8153
Mailing Address - Street 1:10440 QUEENS BLVD APT 19W
Mailing Address - Street 2:
Mailing Address - City:FOREST HILLS
Mailing Address - State:NY
Mailing Address - Zip Code:11375-3657
Mailing Address - Country:US
Mailing Address - Phone:541-974-8153
Mailing Address - Fax:
Practice Address - Street 1:10440 QUEENS BLVD APT 19W
Practice Address - Street 2:
Practice Address - City:FOREST HILLS
Practice Address - State:NY
Practice Address - Zip Code:11375-3657
Practice Address - Country:US
Practice Address - Phone:541-974-8153
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-04-25
Last Update Date:2021-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
No252Y00000XAgenciesEarly Intervention Provider AgencyGroup - Single Specialty