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General NPI Number Information
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NPI Number | 1548327117
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Entity Type | Individual
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Provider Name | JOHN PAUL RINCON MS PT
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Gender | Male
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Dates
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Enumeration Date | 01/03/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 1229 WANTAGH AVENUE SUITE 104
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City | WANTAGH
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State | NY
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Zip | 11793
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Country | US
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Telephone | 516-785-5257
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Fax | 516-785-5154
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Provider Business Mailing Address
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Address Line | 1452 CHAPIN AVENUE
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City | MERRICK
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State | NY
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Zip | 11566
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Country | US
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Telephone | 516-208-6140
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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 | 2251P0200X
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Taxonomy Name | Pediatric Physical Therapist
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License Number | 0223601
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License Number State | NY
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