Healthcare Provider Details

I. General information

NPI: 1205765385
Provider Name (Legal Business Name): KRISTINE MAY SINFUEGO SUIZA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/15/2026
Last Update Date: 05/15/2026
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

51-55 CODWISE PL
ELMHURST NY
11373
US

IV. Provider business mailing address

51-55 CODWISE PL
ELMHURST NY
11373
US

V. Phone/Fax

Practice location:
  • Phone: 718-551-6872
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number054402
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: