=====================================================
General NPI Number Information
=====================================================
NPI Number | 1144105164
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | JOSEPH ANDREW SIGNORINO PT, DPT, DSC, OCS
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/08/2025
-----------------------------------------------------
Last Update Date | 08/08/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1453 BLUEMONT CT
-----------------------------------------------------
City | HERNDON
-----------------------------------------------------
State | VA
-----------------------------------------------------
Zip | 20170-3526
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 571-213-8997
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1453 BLUEMONT CT
-----------------------------------------------------
City | HERNDON
-----------------------------------------------------
State | VA
-----------------------------------------------------
Zip | 20170-3526
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 571-213-8997
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 2251X0800X
-----------------------------------------------------
Taxonomy Name | Orthopedic Physical Therapist
-----------------------------------------------------
License Number | 23052206772
-----------------------------------------------------
License Number State | VA
-----------------------------------------------------