Healthcare Provider Details

I. General information

NPI: 1417198433
Provider Name (Legal Business Name): MICHAEL RICHARD CIRINA DPT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/20/2009
Last Update Date: 03/20/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3-6 NORTHWEST DR
FARMINGDALE NY
11735-4942
US

IV. Provider business mailing address

3-6 NORTHWEST DR
FARMINGDALE NY
11735-4942
US

V. Phone/Fax

Practice location:
  • Phone: 516-420-2900
  • Fax: 516-420-2908
Mailing address:
  • Phone: 516-420-2900
  • Fax: 516-420-2908

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number031253
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: