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General NPI Number Information
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NPI Number | 1801131826
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Entity Type | Individual
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Provider Name | GERTRUDIS SANIDAD PT, DPT
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Gender | Female
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Dates
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Enumeration Date | 12/03/2012
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Last Update Date | 12/03/2012
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Provider Practice Location Address
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Address Line | 112 FRANKLIN CORNER RD
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City | LAWRENCEVILLE
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State | NJ
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Zip | 08648-2104
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Country | US
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Telephone | 609-896-1494
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Fax |
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Provider Business Mailing Address
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Address Line | 8 LONCZAK LN
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City | EAST BRUNSWICK
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State | NJ
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Zip | 08816-5694
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Country | US
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Telephone | 732-613-8032
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Fax |
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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 | 40QA00297800
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License Number State | NJ
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