Provider Demographics
NPI:1578884888
Name:DEYTO, DINDO UY (PT)
Entity Type:Individual
Prefix:MR
First Name:DINDO
Middle Name:UY
Last Name:DEYTO
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4720 CENTER BLVD
Mailing Address - Street 2:APT. 219
Mailing Address - City:LONG ISLAND CITY
Mailing Address - State:NY
Mailing Address - Zip Code:11109-5619
Mailing Address - Country:US
Mailing Address - Phone:718-864-9454
Mailing Address - Fax:718-606-1940
Practice Address - Street 1:463 W 142ND ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10031-6217
Practice Address - Country:US
Practice Address - Phone:212-281-6531
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-06-21
Last Update Date:2010-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY023766225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist