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General NPI Number Information
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NPI Number | 1235103821
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Entity Type | Individual
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Provider Name | ALBERT SAGNELLA MAPT
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Gender | Male
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Dates
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Enumeration Date | 02/13/2006
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Last Update Date | 11/30/2011
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Provider Practice Location Address
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Address Line | 11 1ST AVE
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City | MORICHES
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State | NY
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Zip | 11955-1001
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Country | US
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Telephone | 631-566-2793
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Fax | 631-320-0932
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Provider Business Mailing Address
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Address Line | PO BOX 492
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City | CENTER MORICHES
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State | NY
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Zip | 11934-0492
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Country | US
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Telephone | 631-566-2793
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Fax | 631-320-0932
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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 | 012491
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License Number State | NY
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