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General NPI Number Information
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NPI Number | 1275750291
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Entity Type | Individual
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Provider Name | KEVIN JOHN PARETTI PT
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Gender | Male
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Dates
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Enumeration Date | 04/19/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 121 W 79TH ST APT 4A
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City | NEW YORK
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State | NY
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Zip | 10024-6463
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Country | US
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Telephone | 917-441-0878
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Fax |
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Provider Business Mailing Address
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Address Line | 121 W 79TH ST APT 4A
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City | NEW YORK
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State | NY
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Zip | 10024-6463
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Country | US
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Telephone | 917-441-0878
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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 | 2251S0007X
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Taxonomy Name | Sports Physical Therapist
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License Number | 024344-1
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License Number State | NY
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