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General NPI Number Information
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NPI Number | 1013044460
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Entity Type | Individual
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Provider Name | ANTHONY J ORTOLANO A.T.,C.
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Gender | Male
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Dates
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Enumeration Date | 02/27/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 110 8TH ST
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City | TROY
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State | NY
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Zip | 12180-3522
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Country | US
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Telephone | 518-276-6730
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Fax | 518-276-2059
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Provider Business Mailing Address
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Address Line | 84 DUNHAM HOLLOW RD
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City | EAST NASSAU
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State | NY
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Zip | 12062-2509
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Country | US
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Telephone | 518-766-5658
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2255A2300X
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Taxonomy Name | Athletic Trainer
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License Number | 000204
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License Number State | NY
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