Healthcare Provider Details

I. General information

NPI: 1477922656
Provider Name (Legal Business Name): IVETE SANTOS CLOUD DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/17/2015
Last Update Date: 01/07/2025
Certification Date: 01/07/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2 WINDSOR TER APT 5C
WHITE PLAINS NY
10601-3734
US

IV. Provider business mailing address

2 WINDSOR TER APT 5C
WHITE PLAINS NY
10601-3734
US

V. Phone/Fax

Practice location:
  • Phone: 914-396-7078
  • Fax:
Mailing address:
  • Phone: 914-396-7078
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2251G0304X
TaxonomyGeriatric Physical Therapist
License Number032339-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: