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General NPI Number Information
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NPI Number | 1194988022
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Entity Type | Individual
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Provider Name | ACE GONZALES SUMAGAYSAY PT
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Gender | Male
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Dates
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Enumeration Date | 07/10/2008
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Last Update Date | 11/07/2022
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Provider Practice Location Address
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Address Line | 5875 NIGHT WIND CIR
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City | JAMESVILLE
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State | NY
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Zip | 13078-6475
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Country | US
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Telephone | 718-564-3687
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Fax | 315-359-6778
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Provider Business Mailing Address
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Address Line | 5875 NIGHT WIND CIR
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City | JAMESVILLE
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State | NY
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Zip | 13078-6475
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Country | US
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Telephone | 718-564-3687
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Fax | 315-299-5319
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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 | 027980-1
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 2251G0304X
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Taxonomy Name | Geriatric Physical Therapist
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License Number | 027980
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License Number State | NY
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