Individual provider · NPI-1

Samantha Renee Delorenzo, PTA

Physical Therapy Assistant · Santa Fe, NM

NPI number1023702875
StatusActive
Last updated in NPPESMar 15, 2024

Details

NPI
1023702875
Entity type
Individual (NPI-1)
Name
Samantha Renee Delorenzo
Credential
PTA
Sex
Female
Sole proprietor
Yes
Enumeration date
Jun 5, 2023
Certification date
Mar 15, 2024
Last updated
Mar 15, 2024

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
225200000X Physical Therapy AssistantPT-2024-0037NMYes

Practice location

1650 Galisteo St
Santa Fe, NM 87505-4747

Phone 505-984-8313

Mailing address

8802 Summer Serenade Dr
Huntersville, NC 28078-2362

Phone 973-945-6968

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