MEDICARE: DR. DANIEL RAY DE GRACIA SINDO P.T., DPT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist	017724	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier Issuer
1	182224	OTHER	ELDERPLAN
2	4473457	OTHER	CIGNA
3	0136977	OTHER	GHI
4	205808184	OTHER	MAGNACARE
5	P3740765	OTHER	OXFORD
6	03000005	OTHER	HEALTHNET
7	2517079	OTHER	UNITED HEALTHCARE
8	205808184	OTHER	MULTIPLAN
9	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
10	205808184	OTHER	1199

General Provider Information

NPI Number	:	1578558425
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DANIEL RAY DE GRACIA SINDO P.T., DPT

Provider Business Mailing Address
First Line	:	128-130 BRIGHTON BEACH AVENUE
Second Line	:	SUITE 1, 3RD FLOOR
City	:	BROOKLYN
State	:	NY
Zip	:	11235-8372
Country	:	US
Telephone Number	:	718-996-1854
Fax Number	:	718-996-1694

Provider Business Practice Location Address
First Line	:	128-130 BRIGHTON BEACH AVENUE
Second Line	:	SUITE 1, 3RD FLOOR
City	:	BROOKLYN
State	:	NY
Zip	:	11235-8372
Country	:	US
Telephone Number	:	718-996-1854
Fax Number	:	718-996-1694

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/16/2005
Last Update Date	:	03/21/2013

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