Ace Gonzales Sumagaysay, PT

Individual provider Active NPI Physical Therapist · Jamesville, NY

NPI 1194988022 · NPPES record last updated Nov 7, 2022

Key facts

NPI
1194988022
Entity type
Individual (NPI type 1)
Primary specialty
Physical Therapist 225100000X
License
027980-1 (NY)
Practice address
5875 Night Wind Cir
Jamesville, NY 13078-6475
Phone
(718) 564-3687
Fax
(315) 359-6778
NPI assigned
Jul 10, 2008
Sex
Male
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes

State licenses

LicenseStateTypeSpecialty
027980NYMDGeriatric Physical Therapist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 027980-1 NY Yes
Geriatric Physical Therapist
Group: 193400000X SINGLE SPECIALTY GROUP
2251G0304X 027980 NY

Addresses

Primary practice location

5875 Night Wind Cir
Jamesville, NY 13078-6475

Mailing address

5875 Night Wind Cir
Jamesville, NY 13078-6475
Phone (718) 564-3687

Other providers in Jamesville, NY

All providers in Jamesville, NY · Physical Therapist in New York

Sources for this page

Verify at the official NPI Registry.