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NPI 1104012640

NPI 1104012640 : ACCESS PHYSICAL THERAPY PC : NIAGARA FALLS, NY

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General NPI Number Information
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    NPI Number           |    1104012640
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    Entity Type          |    Organization 
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    Legal Business Name  |    ACCESS PHYSICAL THERAPY PC 
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Dates
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    Enumeration Date     |    09/19/2007
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    Last Update Date     |    02/05/2026
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Provider Practice Location Address
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    Address Line         |    2316 PINE AVE 
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    City                 |    NIAGARA FALLS
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    State                |    NY
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    Zip                  |    14301-2338
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    Country              |    US
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    Telephone            |    716-284-4474
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    Fax                  |    716-284-4484
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Provider Business Mailing Address
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    Address Line         |    2316 PINE AVE 
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    City                 |    NIAGARA FALLS
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    State                |    NY
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    Zip                  |    14301-2338
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    Country              |    US
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    Telephone            |    716-284-4474
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    Fax                  |    716-284-4484
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Authorized Official
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    Title or Position    |    CEO
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    Name                 |    MR. ENRICO  FROSOLONE 
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    Credential           |    PT
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    Telephone            |    716-284-4474
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    225100000X
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    Taxonomy Name        |    Physical Therapist
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    License Number       |    010913-1
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    License Number State |    
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Taxonomy #2
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    Taxonomy Code        |    225100000X
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    Taxonomy Name        |    Physical Therapist
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    License Number       |    017075-1
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    License Number State |    
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Taxonomy #3
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    Taxonomy Code        |    225100000X
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    Taxonomy Name        |    Physical Therapist
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    License Number       |    025797
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    License Number State |    NY
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