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NPI Code Detail

MEDICARE: JOSEPH C. LAIELLI PT

MEDICARE: JOSEPH C. LAIELLI PT
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
1225100000XPhysical Therapist40QA00632700NJ

General Provider Information

NPI Number : 1801961032
Entity Type Code : Individual
Provider Name (Legal Business Name) : JOSEPH C. LAIELLI PT
Provider Business Mailing Address
First Line : 4175 VETERANS MEMORIAL HWY
Second Line : SUITE 202
City : RONKONKOMA
State : NY
Zip : 11779-7639
Country : US
Telephone Number : 631-580-5200
Fax Number : 631-580-5222
Provider Business Practice Location Address
First Line : 547 NEW RD
Second Line :
City : SOMERS POINT
State : NJ
Zip : 08244-2038
Country : US
Telephone Number : 609-927-9200
Fax Number : 609-927-1616
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/22/2006
Last Update Date : 07/23/2009

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Directions to “ JOSEPH C. LAIELLI PT” Practice Location

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