=====================================================
General NPI Number Information
=====================================================
NPI Number | 1588434054
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | THOMAS RINIOLO PT, DPT
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 01/05/2024
-----------------------------------------------------
Last Update Date | 01/27/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1364 MAIN ST STE 6
-----------------------------------------------------
City | SANFORD
-----------------------------------------------------
State | ME
-----------------------------------------------------
Zip | 04073-3648
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 207-881-5014
-----------------------------------------------------
Fax | 866-291-8520
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 655 S WILLOW ST
-----------------------------------------------------
City | MANCHESTER
-----------------------------------------------------
State | NH
-----------------------------------------------------
Zip | 03103-5714
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 800-995-2673
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 225100000X
-----------------------------------------------------
Taxonomy Name | Physical Therapist
-----------------------------------------------------
License Number | 050987
-----------------------------------------------------
License Number State | NY
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 225100000X
-----------------------------------------------------
Taxonomy Name | Physical Therapist
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State | MD
-----------------------------------------------------
Taxonomy #3
-----------------------------------------------------
Taxonomy Code | 225100000X
-----------------------------------------------------
Taxonomy Name | Physical Therapist
-----------------------------------------------------
License Number | PT6671
-----------------------------------------------------
License Number State | ME
-----------------------------------------------------