Provider Demographics
NPI:1205149234
Name:ACE THERAPY SERVICES, PT, PLLC
Entity type:Organization
Organization Name:ACE THERAPY SERVICES, PT, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:ACE
Authorized Official - Middle Name:GONZALES
Authorized Official - Last Name:SUMAGAYSAY
Authorized Official - Suffix:
Authorized Official - Credentials:PT, DPT
Authorized Official - Phone:718-564-3687
Mailing Address - Street 1:5875 NIGHT WIND CIR
Mailing Address - Street 2:
Mailing Address - City:JAMESVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:13078-6475
Mailing Address - Country:US
Mailing Address - Phone:718-564-3687
Mailing Address - Fax:315-299-5319
Practice Address - Street 1:5875 NIGHT WIND CIR
Practice Address - Street 2:
Practice Address - City:JAMESVILLE
Practice Address - State:NY
Practice Address - Zip Code:13078-6475
Practice Address - Country:US
Practice Address - Phone:718-564-3687
Practice Address - Fax:315-359-6778
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-07-19
Last Update Date:2022-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY032206-1225100000X
NY027980-1225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty