Provider Demographics
NPI:1942545967
Name:SAULOG, MARISOL BARRION (PT)
Entity Type:Individual
Prefix:
First Name:MARISOL
Middle Name:BARRION
Last Name:SAULOG
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 1:2 W 86TH ST
Mailing Address - Street 2:SUITE 1
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10024-3666
Mailing Address - Country:US
Mailing Address - Phone:212-787-7994
Mailing Address - Fax:212-595-4716
Practice Address - Street 1:2 W 86TH ST
Practice Address - Street 2:SUITE 1
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10024-3666
Practice Address - Country:US
Practice Address - Phone:212-787-7994
Practice Address - Fax:212-595-4716
Is Sole Proprietor?:No
Enumeration Date:2012-12-02
Last Update Date:2012-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY20546225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist