Provider Demographics
NPI:1861815516
Name:SANTOS, LOUIE JAMES NUYDA (PT)
Entity type:Individual
Prefix:MR
First Name:LOUIE JAMES
Middle Name:NUYDA
Last Name:SANTOS
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:188 WHITE SANDS WAY UNIT B
Mailing Address - Street 2:
Mailing Address - City:ARVERNE
Mailing Address - State:NY
Mailing Address - Zip Code:11692-1259
Mailing Address - Country:US
Mailing Address - Phone:971-312-8027
Mailing Address - Fax:
Practice Address - Street 1:188 WHITE SANDS WAY UNIT B
Practice Address - Street 2:
Practice Address - City:ARVERNE
Practice Address - State:NY
Practice Address - Zip Code:11692-1259
Practice Address - Country:US
Practice Address - Phone:971-312-8027
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-01-31
Last Update Date:2024-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR60378225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist