Provider Demographics
NPI:1841407103
Name:STO TOMAS, VINCENT (PT, DPT)
Entity Type:Individual
Prefix:MR
First Name:VINCENT
Middle Name:
Last Name:STO TOMAS
Suffix:
Gender:M
Credentials:PT, DPT
Other - Prefix:DR
Other - First Name:VINCENT
Other - Middle Name:
Other - Last Name:STO TOMAS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PT, DPT
Mailing Address - Street 1:38 DEERFIELD ST
Mailing Address - Street 2:
Mailing Address - City:BERGENFIELD
Mailing Address - State:NJ
Mailing Address - Zip Code:07621-1805
Mailing Address - Country:US
Mailing Address - Phone:718-839-3046
Mailing Address - Fax:
Practice Address - Street 1:1537 WASHINGTON AVE
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10457-8308
Practice Address - Country:US
Practice Address - Phone:718-583-2913
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-17
Last Update Date:2020-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY025256225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist