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General NPI Number Information
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NPI Number | 1184263618
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Entity Type | Individual
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Provider Name | KATRINA PIZZICHETTA PT, DPT
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Gender | Female
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Dates
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Enumeration Date | 01/01/2020
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Last Update Date | 01/01/2020
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Provider Practice Location Address
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Address Line | 225 SUMMIT AVE
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City | MONTVALE
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State | NJ
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Zip | 07645-1523
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Country | US
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Telephone | 201-775-7416
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Fax |
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Provider Business Mailing Address
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Address Line | 179 WOODLANDS DR
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City | TUXEDO PARK
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State | NY
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Zip | 10987-4803
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Country | US
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Telephone | 845-271-9490
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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 | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 037442
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License Number State | NY
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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 | 40QA01797600
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License Number State | NJ
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