Healthcare Provider Details

I. General information

NPI: 1114400421
Provider Name (Legal Business Name): ANGELA RITIENI PHYSICAL THERAPIST, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/12/2018
Last Update Date: 09/26/2023
Certification Date: 09/26/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5 FORSYTHIA CT
MILLER PLACE NY
11764-3041
US

IV. Provider business mailing address

5 FORSYTHIA CT
MILLER PLACE NY
11764-3041
US

V. Phone/Fax

Practice location:
  • Phone: 516-770-8656
  • Fax:
Mailing address:
  • Phone: 516-770-8656
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QR0400X
TaxonomyRehabilitation Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. ANGELA M. RITIENI
Title or Position: PRESIDENT
Credential: PT, DPT
Phone: 516-770-8656