Provider Demographics
NPI:1497403216
Name:SANCHEZ, CRISTINA MAE (PTA)
Entity Type:Individual
Prefix:MISS
First Name:CRISTINA
Middle Name:MAE
Last Name:SANCHEZ
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7 GLEN HOLLOW DR APT B44
Mailing Address - Street 2:
Mailing Address - City:HOLTSVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:11742-2449
Mailing Address - Country:US
Mailing Address - Phone:714-609-3479
Mailing Address - Fax:
Practice Address - Street 1:81 FORT SALONGA RD STE C
Practice Address - Street 2:
Practice Address - City:NORTHPORT
Practice Address - State:NY
Practice Address - Zip Code:11768-2889
Practice Address - Country:US
Practice Address - Phone:631-380-3820
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-03-10
Last Update Date:2022-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY012602225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant