Provider Demographics
NPI:1275723678
Name:SANEZ, LORENCE A (PT, PTRP)
Entity Type:Individual
Prefix:MR
First Name:LORENCE
Middle Name:A
Last Name:SANEZ
Suffix:
Gender:M
Credentials:PT, PTRP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4 TUPELO DR
Mailing Address - Street 2:
Mailing Address - City:OLD BRIDGE
Mailing Address - State:NJ
Mailing Address - Zip Code:08857-2943
Mailing Address - Country:US
Mailing Address - Phone:732-416-8990
Mailing Address - Fax:
Practice Address - Street 1:6989 ROUTE 18
Practice Address - Street 2:
Practice Address - City:OLD BRIDGE
Practice Address - State:NJ
Practice Address - Zip Code:08857-3345
Practice Address - Country:US
Practice Address - Phone:732-360-2277
Practice Address - Fax:732-360-0560
Is Sole Proprietor?:No
Enumeration Date:2007-07-31
Last Update Date:2007-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA01199700225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist