Provider Demographics
NPI:1437627874
Name:HENDRY, SAMANTHA CELESTE (DPT)
Entity Type:Individual
Prefix:
First Name:SAMANTHA
Middle Name:CELESTE
Last Name:HENDRY
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:136 BLACHLEY RD APT B
Mailing Address - Street 2:
Mailing Address - City:STAMFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06902-4301
Mailing Address - Country:US
Mailing Address - Phone:631-487-1827
Mailing Address - Fax:
Practice Address - Street 1:317 NORTH ST
Practice Address - Street 2:
Practice Address - City:WHITE PLAINS
Practice Address - State:NY
Practice Address - Zip Code:10605-2209
Practice Address - Country:US
Practice Address - Phone:914-597-4071
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-11-04
Last Update Date:2019-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYP132562251P0200X
NY0437122251P0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatrics