| Doctor Name: | MARICRIS FORMOSO-SANTOS |
| NPI Number: | 1427284025 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | P.T. |
| License Number: | 40QA01313000 |
| Business Practice Address: | 3222 92nd St 401 East Elmhurst, NY - 113692460 |
| Business Phone Number: | 6469184670 |
| Business Fax Number: | |
| Mailing Address: | 3222 92nd St, 401 EAST ELMHURST |
| State: | NY |
| Postal Code: | 113692460 |
| Phone Number: | |
| Fax Number: | |
| NPI Enumeration Date: | 06/09/2009 |
| NPI Last Update Date: | 12/13/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 225100000X |
| License Number: | 40QA01313000 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | NJ |
| Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Taxonomy Classification: | Physical Therapist |
| Taxonomy Specialization: | |
| Taxonomy Definition: | (1) Physical therapists are health care professionals who evaluate and treat people with health problems resulting from injury or disease. PT |