Provider Demographics
NPI:1124352497
Name:BENSAN, SANDRA MAHUSAY (RPT)
Entity type:Individual
Prefix:
First Name:SANDRA
Middle Name:MAHUSAY
Last Name:BENSAN
Suffix:
Gender:F
Credentials:RPT
Other - Prefix:
Other - First Name:SANDRA
Other - Middle Name:NALL
Other - Last Name:MAHUSAY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RPT
Mailing Address - Street 1:849 UNIVERSITY BLVD
Mailing Address - Street 2:APT.#205
Mailing Address - City:JUPITER
Mailing Address - State:FL
Mailing Address - Zip Code:33458-3079
Mailing Address - Country:US
Mailing Address - Phone:646-515-0986
Mailing Address - Fax:
Practice Address - Street 1:849 UNIVERSITY BLVD
Practice Address - Street 2:APT.#205
Practice Address - City:JUPITER
Practice Address - State:FL
Practice Address - Zip Code:33458-3079
Practice Address - Country:US
Practice Address - Phone:646-515-0986
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-09-19
Last Update Date:2009-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL24859225100000X
NY026829225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist