Provider Demographics
NPI:1558191858
Name:SANDOVAL, ESMERALDA ELVIRA (DPT)
Entity type:Individual
Prefix:
First Name:ESMERALDA
Middle Name:ELVIRA
Last Name:SANDOVAL
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8 ALLEGHENY CTR APT 914
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15212-5233
Mailing Address - Country:US
Mailing Address - Phone:310-339-1039
Mailing Address - Fax:
Practice Address - Street 1:300 CHAPEL HARBOR DR
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15238-4131
Practice Address - Country:US
Practice Address - Phone:412-781-0602
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-08-02
Last Update Date:2024-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT032428225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist