MEDICARE: DOMINICK NAPOLETANO P.T

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist	025558-1	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	025558	OTHER	NY	LICENSE

General Provider Information

NPI Number	:	1801084298
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DOMINICK NAPOLETANO P.T

Provider Business Mailing Address
First Line	:	239 SEAVIEW AVE
Second Line	:
City	:	STATEN ISLAND
State	:	NY
Zip	:	10305-1219
Country	:	US
Telephone Number	:	718-253-3900
Fax Number	:	718-258-7844

Provider Business Practice Location Address
First Line	:	3508 FLATLANDS AVE
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11234-2609
Country	:	US
Telephone Number	:	718-253-3900
Fax Number	:	718-258-7844

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/10/2007
Last Update Date	:	04/23/2017

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