Provider Demographics
NPI:1942234877
Name:SAINT MARY PHYSICAL THERAPY P.C.
Entity Type:Organization
Organization Name:SAINT MARY PHYSICAL THERAPY P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICAL THERAPIST
Authorized Official - Prefix:MR
Authorized Official - First Name:USAMA
Authorized Official - Middle Name:ABDUL-SAYED
Authorized Official - Last Name:HANNA
Authorized Official - Suffix:JR
Authorized Official - Credentials:PT
Authorized Official - Phone:917-545-9249
Mailing Address - Street 1:2071 CLOVE RD
Mailing Address - Street 2:
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10304-1671
Mailing Address - Country:US
Mailing Address - Phone:917-545-9249
Mailing Address - Fax:
Practice Address - Street 1:2071 CLOVE RD
Practice Address - Street 2:
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10304-1671
Practice Address - Country:US
Practice Address - Phone:917-545-9249
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-10
Last Update Date:2008-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY025663174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY025663OtherPHYSICAL THERAPIST