Provider Demographics
NPI:1558181586
Name:SANDICO, PATRICIA LHARA CORSINO (DPT)
Entity type:Individual
Prefix:MS
First Name:PATRICIA LHARA
Middle Name:CORSINO
Last Name:SANDICO
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:651 ACADEMY ST
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10034-5003
Mailing Address - Country:US
Mailing Address - Phone:718-509-4949
Mailing Address - Fax:212-858-0657
Practice Address - Street 1:577 W 161ST ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10032-6101
Practice Address - Country:US
Practice Address - Phone:646-833-7559
Practice Address - Fax:212-858-0657
Is Sole Proprietor?:No
Enumeration Date:2024-10-15
Last Update Date:2024-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY045329-01225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist