Provider Demographics
NPI:1225494115
Name:SANTAMARIA GONZALEZ, VICTOR FRANCISCO (PT, MS, PHD)
Entity Type:Individual
Prefix:DR
First Name:VICTOR
Middle Name:FRANCISCO
Last Name:SANTAMARIA GONZALEZ
Suffix:
Gender:M
Credentials:PT, MS, PHD
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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 1:311 E 94TH ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10128-5683
Practice Address - Country:US
Practice Address - Phone:646-315-1548
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-01-07
Last Update Date:2021-08-11
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY0397062251P0200X, 225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatrics
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist