Provider Demographics
NPI:1801267257
Name:UY, MARIGOLD POINSETTIA
Entity type:Individual
Prefix:
First Name:MARIGOLD POINSETTIA
Middle Name:
Last Name:UY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13203 SANFORD AVE # 1C1D
Mailing Address - Street 2:1C/1D
Mailing Address - City:FLUSHING
Mailing Address - State:NY
Mailing Address - Zip Code:11355-4309
Mailing Address - Country:US
Mailing Address - Phone:718-961-8881
Mailing Address - Fax:
Practice Address - Street 1:13203 SANFORD AVE # 1C1D
Practice Address - Street 2:1C/1D
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11355-4309
Practice Address - Country:US
Practice Address - Phone:718-961-8881
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-10-12
Last Update Date:2015-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY038805225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist