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General NPI Number Information
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NPI Number | 1801181029
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Entity Type | Individual
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Provider Name | MA FATIMA C ISIDRO PT, DPT
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Gender | Female
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Dates
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Enumeration Date | 06/15/2011
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Last Update Date | 06/15/2011
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Provider Practice Location Address
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Address Line | 800 MANOR RD
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City | STATEN ISLAND
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State | NY
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Zip | 10314-7036
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Country | US
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Telephone | 718-477-7960
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Fax |
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Provider Business Mailing Address
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Address Line | 562 OXFORD RD
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City | CEDARHURST
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State | NY
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Zip | 11516-1023
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Country | US
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Telephone | 347-276-8608
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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 | 027135
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License Number State | NY
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