Provider Demographics
NPI:1427317171
Name:SADOL, GENELYN MAE PINERA (PT)
Entity type:Individual
Prefix:
First Name:GENELYN MAE
Middle Name:PINERA
Last Name:SADOL
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 1:15 ESSER PL
Mailing Address - Street 2:
Mailing Address - City:BERGENFIELD
Mailing Address - State:NJ
Mailing Address - Zip Code:07621-1809
Mailing Address - Country:US
Mailing Address - Phone:347-694-0127
Mailing Address - Fax:
Practice Address - Street 1:15 ESSER PL
Practice Address - Street 2:
Practice Address - City:BERGENFIELD
Practice Address - State:NJ
Practice Address - Zip Code:07621-1809
Practice Address - Country:US
Practice Address - Phone:347-694-0127
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-05-15
Last Update Date:2023-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0296881225100000X
NY029688-1225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist