Provider Demographics
NPI:1861720732
Name:SISON, MARIA MIRASOL SANCHEZ (RPT)
Entity type:Individual
Prefix:MS
First Name:MARIA MIRASOL
Middle Name:SANCHEZ
Last Name:SISON
Suffix:
Gender:F
Credentials:RPT
Other - Prefix:
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Mailing Address - Street 1:37 WEST 26TH STREET
Mailing Address - Street 2:SUITE 302
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10010
Mailing Address - Country:US
Mailing Address - Phone:718-285-0588
Mailing Address - Fax:718-285-9323
Practice Address - Street 1:37 WEST 26TH STREET
Practice Address - Street 2:SUITE 302
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10010
Practice Address - Country:US
Practice Address - Phone:718-285-0588
Practice Address - Fax:718-285-9323
Is Sole Proprietor?:No
Enumeration Date:2009-12-03
Last Update Date:2009-12-03
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist