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General NPI Number Information
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NPI Number | 1679649883
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Entity Type | Organization
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Legal Business Name | SANVIN PHYSICAL THERAPY PC
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Dates
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Enumeration Date | 11/28/2006
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Last Update Date | 06/17/2015
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Provider Practice Location Address
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Address Line | 371 2ND AVE
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City | NEW YORK
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State | NY
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Zip | 10010-6447
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Country | US
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Telephone | 212-420-7280
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Fax | 212-420-7422
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Provider Business Mailing Address
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Address Line | 371 2ND AVE
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City | NEW YORK
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State | NY
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Zip | 10010-6447
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Country | US
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Telephone | 212-420-7280
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Fax | 212-420-7422
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Authorized Official
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Title or Position | PRESIDENT
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Name | JOANN SANTOS VINLUAN
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Credential | BSPT
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Telephone | 212-420-7280
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 021012
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License Number State | NY
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