Provider Demographics
NPI:1750699625
Name:HIDALGO, MICHELINE SANCHEZ (PT)
Entity type:Individual
Prefix:MS
First Name:MICHELINE
Middle Name:SANCHEZ
Last Name:HIDALGO
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:MICHELINE
Other - Middle Name:SANCHEZ
Other - Last Name:TADEO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:11801 101ST AVE
Mailing Address - Street 2:
Mailing Address - City:SOUTH RICHMOND HILL
Mailing Address - State:NY
Mailing Address - Zip Code:11419-1229
Mailing Address - Country:US
Mailing Address - Phone:171-880-5711
Mailing Address - Fax:
Practice Address - Street 1:10 WALDRON AVE
Practice Address - Street 2:
Practice Address - City:NYACK
Practice Address - State:NY
Practice Address - Zip Code:10960-2965
Practice Address - Country:US
Practice Address - Phone:845-643-8200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-09-14
Last Update Date:2024-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY023458-1225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist