Healthcare Provider Details

I. General information

NPI: 1487476255
Provider Name (Legal Business Name): LINA SALAZAR PTA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/31/2024
Last Update Date: 10/31/2024
Certification Date: 10/31/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

820 HEMPSTEAD TPKE
FRANKLIN SQUARE NY
11010-4339
US

IV. Provider business mailing address

1021 ADAMS AVE
FRANKLIN SQUARE NY
11010-2212
US

V. Phone/Fax

Practice location:
  • Phone: 516-358-8911
  • Fax:
Mailing address:
  • Phone: 516-567-1071
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225200000X
TaxonomyPhysical Therapy Assistant
License Number005568
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: