Provider Demographics
NPI:1922529676
Name:SINIO, GLENDA DIMITUI (PT)
Entity Type:Individual
Prefix:
First Name:GLENDA
Middle Name:DIMITUI
Last Name:SINIO
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:34 MARCONI ST STE 215
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10461-2761
Mailing Address - Country:US
Mailing Address - Phone:800-668-5972
Mailing Address - Fax:917-832-6114
Practice Address - Street 1:34 MARCONI ST STE 215
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10461-2761
Practice Address - Country:US
Practice Address - Phone:800-668-5972
Practice Address - Fax:917-832-6114
Is Sole Proprietor?:Yes
Enumeration Date:2017-07-03
Last Update Date:2020-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY041521225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty