Provider Demographics
NPI:1780609438
Name:SANZIO, PETER M (PT)
Entity type:Individual
Prefix:MR
First Name:PETER
Middle Name:M
Last Name:SANZIO
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21 MANOR PKWY
Mailing Address - Street 2:
Mailing Address - City:LINCROFT
Mailing Address - State:NJ
Mailing Address - Zip Code:07738-1309
Mailing Address - Country:US
Mailing Address - Phone:732-842-4581
Mailing Address - Fax:
Practice Address - Street 1:315 HIGHWAY 35
Practice Address - Street 2:
Practice Address - City:RED BANK
Practice Address - State:NJ
Practice Address - Zip Code:07701-5913
Practice Address - Country:US
Practice Address - Phone:732-345-9911
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-13
Last Update Date:2007-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA01200200225100000X
NY019944-1225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYQL0891Medicare PIN
NJ105018TT0Medicare PIN