Provider Demographics
NPI:1811365133
Name:SANTOS, NOELIA (DPT)
Entity type:Individual
Prefix:
First Name:NOELIA
Middle Name:
Last Name:SANTOS
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14 CINDER RD
Mailing Address - Street 2:
Mailing Address - City:GARNERVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:10923-1114
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:521 ROUTE 111 STE 107
Practice Address - Street 2:
Practice Address - City:HAUPPAUGE
Practice Address - State:NY
Practice Address - Zip Code:11788-4358
Practice Address - Country:US
Practice Address - Phone:631-724-9509
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-09-02
Last Update Date:2024-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV5049225100000X
IN05014985A225100000X
COPTL.0014482225100000X
RIPT03609225100000X
KS11-07208225100000X
ALPTH11238225100000X
MA26625225100000X
DC210002230225100000X
HIPT-5597225100000X
OR63909225100000X
FLPT37757225100000X
CT13866225100000X
SC11704225100000X
NY038316225100000X
NY62 038316225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist