Healthcare Provider Details

I. General information

NPI: 1548636517
Provider Name (Legal Business Name): MARCELLO SARRICA P.T., P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/13/2015
Last Update Date: 08/13/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

474 BAY RIDGE PKWY
BROOKLYN NY
11209-2702
US

IV. Provider business mailing address

474 BAY RIDGE PKWY
BROOKLYN NY
11209-2702
US

V. Phone/Fax

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

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number028696
License Number StateNY

VIII. Authorized Official

Name: DR. MARCELLO SARRICA
Title or Position: OWNER - PHYSICAL THERAPIST
Credential: DPT
Phone: 347-560-6920