Provider Demographics
NPI:1578558425
Name:SINDO, DANIEL RAY DE GRACIA (PT, DPT)
Entity Type:Individual
Prefix:DR
First Name:DANIEL RAY
Middle Name:DE GRACIA
Last Name:SINDO
Suffix:
Gender:M
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:128-130 BRIGHTON BEACH AVENUE
Mailing Address - Street 2:SUITE 1, 3RD FLOOR
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11235-8372
Mailing Address - Country:US
Mailing Address - Phone:718-996-1854
Mailing Address - Fax:718-996-1694
Practice Address - Street 1:128-130 BRIGHTON BEACH AVENUE
Practice Address - Street 2:SUITE 1, 3RD FLOOR
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11235-8372
Practice Address - Country:US
Practice Address - Phone:718-996-1854
Practice Address - Fax:718-996-1694
Is Sole Proprietor?:Yes
Enumeration Date:2005-09-16
Last Update Date:2013-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY017724225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
182224OtherELDERPLAN
4473457OtherCIGNA
0136977OtherGHI
205808184OtherMAGNACARE
P3740765OtherOXFORD
03000005OtherHEALTHNET
2517079OtherUNITED HEALTHCARE
205808184OtherMULTIPLAN
NY02657674Medicaid
205808184Other1199
QN9401Medicare PIN
205808184OtherMAGNACARE