Provider Demographics
NPI:1710989413
Name:SAMONTE, LEOPOLDO D (PT)
Entity Type:Individual
Prefix:MR
First Name:LEOPOLDO
Middle Name:D
Last Name:SAMONTE
Suffix:
Gender:M
Credentials:PT
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Mailing Address - Street 1:2318 31ST ST
Mailing Address - Street 2:SUITE 210
Mailing Address - City:ASTORIA
Mailing Address - State:NY
Mailing Address - Zip Code:11105-2892
Mailing Address - Country:US
Mailing Address - Phone:718-777-1885
Mailing Address - Fax:718-777-9613
Practice Address - Street 1:2318 31ST ST
Practice Address - Street 2:SUITE 210
Practice Address - City:ASTORIA
Practice Address - State:NY
Practice Address - Zip Code:11105-2892
Practice Address - Country:US
Practice Address - Phone:718-777-1885
Practice Address - Fax:718-777-9613
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-08-11
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY026092225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYQ25162Medicare UPIN