Basic Information
| Provider Information | |||||||||
| NPI: | 1770632218 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | FOSCHI | ||||||||
| FirstName: | SANDRA | ||||||||
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| Credential: | MSPT | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1255 5TH AVE | ||||||||
| Address2: | #6L | ||||||||
| City: | NEW YORK | ||||||||
| State: | NY | ||||||||
| PostalCode: | 100293852 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9144001500 | ||||||||
| FaxNumber: | 9144788781 | ||||||||
| Practice Location | |||||||||
| Address1: | 139 E 57TH ST | ||||||||
| Address2: | 3RD FLOOR | ||||||||
| City: | NEW YORK | ||||||||
| State: | NY | ||||||||
| PostalCode: | 100222102 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9144001500 | ||||||||
| FaxNumber: | 9144788781 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/10/2007 | ||||||||
| LastUpdateDate: | 02/24/2015 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225100000X | 010474 | NY | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist |
ID Information
| ID | Type | State | Issuer | Description | P00424956 | 01 | NY | MEDICARE RAILROAD | OTHER |