MEDICARE: GLENDA DIMITUI SINIO PT

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	041521	NY

General Provider Information

NPI Number	:	1922529676
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GLENDA DIMITUI SINIO PT

Provider Business Mailing Address
First Line	:	34 MARCONI ST STE 215
Second Line	:
City	:	BRONX
State	:	NY
Zip	:	10461-2761
Country	:	US
Telephone Number	:	800-668-5972
Fax Number	:	917-832-6114

Provider Business Practice Location Address
First Line	:	34 MARCONI ST STE 215
Second Line	:
City	:	BRONX
State	:	NY
Zip	:	10461-2761
Country	:	US
Telephone Number	:	800-668-5972
Fax Number	:	917-832-6114

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

Provider Enumeration Date	:	07/03/2017
Last Update Date	:	01/29/2020

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