Provider Demographics
NPI:1770106726
Name:SANDIA SUNRISE THERAPY LLC
Entity type:Organization
Organization Name:SANDIA SUNRISE THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OCCUPATIONAL THERAPY
Authorized Official - Prefix:
Authorized Official - First Name:TERESA
Authorized Official - Middle Name:
Authorized Official - Last Name:ZIOMEK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:505-302-6850
Mailing Address - Street 1:9550 SAN MATEO BLVD NE STE A
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87113-2313
Mailing Address - Country:US
Mailing Address - Phone:505-302-6850
Mailing Address - Fax:505-672-5137
Practice Address - Street 1:9550 SAN MATEO BLVD NE STE A
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87113-2313
Practice Address - Country:US
Practice Address - Phone:505-302-6850
Practice Address - Fax:505-672-5137
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-05-26
Last Update Date:2021-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatricsGroup - Multi-Specialty
No2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatricsGroup - Multi-Specialty
No235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty