Provider Demographics
NPI:1104071091
Name:SALDITOS, SANDRA MAE BASCO (PT)
Entity type:Individual
Prefix:MISS
First Name:SANDRA MAE
Middle Name:BASCO
Last Name:SALDITOS
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1806 26TH AVE
Mailing Address - Street 2:SECOND FLOOR
Mailing Address - City:ASTORIA
Mailing Address - State:NY
Mailing Address - Zip Code:11102-3542
Mailing Address - Country:US
Mailing Address - Phone:646-546-6695
Mailing Address - Fax:
Practice Address - Street 1:1806 26TH AVE
Practice Address - Street 2:SECOND FLOOR
Practice Address - City:ASTORIA
Practice Address - State:NY
Practice Address - Zip Code:11102-3542
Practice Address - Country:US
Practice Address - Phone:646-546-6695
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-11-19
Last Update Date:2008-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY027793-1225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist