Provider Demographics
NPI:1538978762
Name:SORIANO, GLENDY
Entity type:Individual
Prefix:
First Name:GLENDY
Middle Name:
Last Name:SORIANO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1020 GALLOPING HILL RD STE 300
Mailing Address - Street 2:
Mailing Address - City:UNION
Mailing Address - State:NJ
Mailing Address - Zip Code:07083-7999
Mailing Address - Country:US
Mailing Address - Phone:908-349-8654
Mailing Address - Fax:908-573-8337
Practice Address - Street 1:1020 GALLOPING HILL RD STE 300
Practice Address - Street 2:
Practice Address - City:UNION
Practice Address - State:NJ
Practice Address - Zip Code:07083-7999
Practice Address - Country:US
Practice Address - Phone:908-349-8654
Practice Address - Fax:908-573-8337
Is Sole Proprietor?:No
Enumeration Date:2025-01-02
Last Update Date:2025-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QB00416200225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant