Provider Demographics
NPI:1285942060
Name:SANZ, GLADYS EDITH (PT)
Entity type:Individual
Prefix:
First Name:GLADYS
Middle Name:EDITH
Last Name:SANZ
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 1:1414 119TH ST
Mailing Address - Street 2:
Mailing Address - City:COLLEGE POINT
Mailing Address - State:NY
Mailing Address - Zip Code:11356-1621
Mailing Address - Country:US
Mailing Address - Phone:917-734-7870
Mailing Address - Fax:917-285-2061
Practice Address - Street 1:1414 119TH ST
Practice Address - Street 2:
Practice Address - City:COLLEGE POINT
Practice Address - State:NY
Practice Address - Zip Code:11356-1621
Practice Address - Country:US
Practice Address - Phone:917-734-7870
Practice Address - Fax:917-285-2061
Is Sole Proprietor?:Yes
Enumeration Date:2010-09-15
Last Update Date:2010-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0159932251P0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatrics