Healthcare Provider Details

I. General information

NPI: 1083858187
Provider Name (Legal Business Name): SVETLANA SANDLER PT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/21/2009
Last Update Date: 04/21/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

51 PLATTSBURG ST
STATEN ISLAND NY
10304-3966
US

IV. Provider business mailing address

51 PLATTSBURG ST
STATEN ISLAND NY
10304-3966
US

V. Phone/Fax

Practice location:
  • Phone: 718-930-4428
  • Fax: 718-524-5981
Mailing address:
  • Phone: 718-930-4428
  • Fax: 718-524-5981

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number025685-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: