Healthcare Provider Details

I. General information

NPI: 1558909630
Provider Name (Legal Business Name): THOMAS CILIBERTO PT DPT
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/19/2019
Last Update Date: 12/19/2019
Certification Date: 12/19/2019
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1980 CROMPOND RD
CORTLANDT MANOR NY
10567-4144
US

IV. Provider business mailing address

1980 CROMPOND RD
CORTLANDT MANOR NY
10567-4144
US

V. Phone/Fax

Practice location:
  • Phone: 914-734-3251
  • Fax:
Mailing address:
  • Phone: 914-734-3251
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: