Healthcare Provider Details

I. General information

NPI: 1568582435
Provider Name (Legal Business Name): JOHN J FORGIONE P.T.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/02/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

321 REGENT DR
LITITZ PA
17543-8303
US

IV. Provider business mailing address

321 REGENT DR
LITITZ PA
17543-8303
US

V. Phone/Fax

Practice location:
  • Phone: 717-368-0227
  • Fax: 717-625-2607
Mailing address:
  • Phone: 717-368-0227
  • Fax: 717-625-2607

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT016889
License Number StatePA

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: