Provider Demographics
NPI:1710587043
Name:GOMES, SANDRA REIS (PT, DPT)
Entity Type:Individual
Prefix:
First Name:SANDRA
Middle Name:REIS
Last Name:GOMES
Suffix:
Gender:F
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 1:217 N FULTON AVE
Mailing Address - Street 2:
Mailing Address - City:MOUNT VERNON
Mailing Address - State:NY
Mailing Address - Zip Code:10552-3301
Mailing Address - Country:US
Mailing Address - Phone:914-572-5505
Mailing Address - Fax:
Practice Address - Street 1:175 TOMPKINS AVE
Practice Address - Street 2:
Practice Address - City:PLEASANTVILLE
Practice Address - State:NY
Practice Address - Zip Code:10570-3144
Practice Address - Country:US
Practice Address - Phone:914-919-2888
Practice Address - Fax:914-462-3444
Is Sole Proprietor?:No
Enumeration Date:2020-10-27
Last Update Date:2020-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist