Provider Demographics
NPI:1043288236
Name:SANTOS, JOHN PATRICK (PT)
Entity type:Individual
Prefix:
First Name:JOHN
Middle Name:PATRICK
Last Name:SANTOS
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:132 TYRRELL ST
Mailing Address - Street 2:
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10307-1166
Mailing Address - Country:US
Mailing Address - Phone:718-227-3218
Mailing Address - Fax:718-227-3218
Practice Address - Street 1:132 TYRRELL ST
Practice Address - Street 2:
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10307-1166
Practice Address - Country:US
Practice Address - Phone:718-227-3218
Practice Address - Fax:718-227-3218
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-14
Last Update Date:2025-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY015652-1225100000X, 2251G0304X, 2251P0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251G0304XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGeriatrics
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatrics