Healthcare Provider Details

I. General information

NPI: 1780863027
Provider Name (Legal Business Name): MARCELLO SARRICA D.P.T.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/02/2007
Last Update Date: 11/08/2024
Certification Date: 11/08/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7606 7TH AVE
BROOKLYN NY
11209-3321
US

IV. Provider business mailing address

7606 7TH AVE
BROOKLYN NY
11209-3321
US

V. Phone/Fax

Practice location:
  • Phone: 347-560-6920
  • Fax: 347-560-6748
Mailing address:
  • Phone: 917-603-7848
  • Fax: 347-560-6748

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2251S0007X
TaxonomySports Physical Therapist
License Number028696
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number028696
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: