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General NPI Number Information
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NPI Number | 1376928523
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Entity Type | Individual
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Provider Name | JOSEPH CANNISI DPT, ATC
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Gender | Male
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Dates
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Enumeration Date | 07/29/2015
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 1940 HEMPSTEAD TPKE
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City | EAST MEADOW
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State | NY
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Zip | 11554-1712
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Country | US
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Telephone | 516-359-8572
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Fax |
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Provider Business Mailing Address
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Address Line | 1940 HEMPSTEAD TPKE
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City | EAST MEADOW
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State | NY
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Zip | 11554-1712
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Country | US
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Telephone | 516-359-8572
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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 | 0395241
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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 | 8262
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License Number State | SC
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