Healthcare Provider Details

I. General information

NPI: 1023314093
Provider Name (Legal Business Name): ALL RIVERDALE PHYSICAL THERAPY, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/08/2011
Last Update Date: 10/24/2024
Certification Date: 10/24/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3424 KINGSBRIDGE AVE APT 1H
BRONX NY
10463-4002
US

IV. Provider business mailing address

444 W 259TH ST APT 1
BRONX NY
10471-1622
US

V. Phone/Fax

Practice location:
  • Phone: 718-884-2460
  • Fax: 888-543-7447
Mailing address:
  • Phone: 718-884-4260
  • Fax: 888-543-7447

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number008557
License Number StateNY

VIII. Authorized Official

Name: DIONISIO MAURO
Title or Position: PRESIDENT
Credential:
Phone: 718-884-8248