Provider Demographics
NPI:1851465785
Name:SARINYAMAS, JOY (MPT)
Entity Type:Individual
Prefix:
First Name:JOY
Middle Name:
Last Name:SARINYAMAS
Suffix:
Gender:F
Credentials:MPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 15TH AVE
Mailing Address - Street 2:#180
Mailing Address - City:SOUTH MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53172-1160
Mailing Address - Country:US
Mailing Address - Phone:414-768-5430
Mailing Address - Fax:414-762-4225
Practice Address - Street 1:S74W16775 JANESVILLE RD
Practice Address - Street 2:SUITE 120
Practice Address - City:MUSKEGO
Practice Address - State:WI
Practice Address - Zip Code:53150-7742
Practice Address - Country:US
Practice Address - Phone:414-422-2191
Practice Address - Fax:414-422-2193
Is Sole Proprietor?:No
Enumeration Date:2006-11-20
Last Update Date:2015-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI10110-24225100000X
IL070-014276225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI02120-Medicare PIN