Mary Sanguedolce, MPT

Primary specialty

Pediatric Physical TherapistTaxonomy code 2251P0200X

License

015027 Issued in NY

Practice address

168 Cherry LN
Carle Place, NY 11514-1741

Phone

(516) 622-6402

NPI assigned

Jan 30, 2007

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1170115200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1316084635",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "63 TITUS AVE",
            "city": "CARLE PLACE",
            "state": "NY",
            "postal_code": "115141312",
            "telephone_number": "516-334-2041"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "168 CHERRY LN",
            "city": "CARLE PLACE",
            "state": "NY",
            "postal_code": "115141741",
            "telephone_number": "516-622-6402"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANGUEDOLCE",
        "first_name": "MARY",
        "name_prefix": "Mrs.",
        "credential": "MPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-30",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251P0200X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Pediatrics",
            "state": "NY",
            "license": "015027",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Senior Life Management, P.L.L.C.

• Pediatric Physical Therapist in Carle Place, NY
• Providers in Carle Place, NY by specialty
• Pediatric Physical Therapist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.