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General NPI Number Information
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NPI Number | 1174687719
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Entity Type | Individual
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Provider Name | RICHARD MARK SARMIENTO P.T.
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Gender | Male
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Dates
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Enumeration Date | 12/20/2006
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Last Update Date | 08/21/2013
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Provider Practice Location Address
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Address Line | 12 W 21ST ST 2ND FLOOR
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City | NEW YORK
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State | NY
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Zip | 10010-6902
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Country | US
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Telephone | 646-484-5763
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Fax | 347-287-6873
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Provider Business Mailing Address
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Address Line | 2130 VAUXHALL RD
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City | UNION
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State | NJ
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Zip | 07083-5875
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Country | US
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Telephone | 212-810-9347
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Fax | 347-438-3362
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 022608-1
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License Number State | NY
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