=====================================================
General NPI Number Information
=====================================================
NPI Number | 1649792789
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | RICK FRANCIS D'ANDREA JR. DPT
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 07/11/2017
-----------------------------------------------------
Last Update Date | 07/07/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 102 MADISON AVE FL 8
-----------------------------------------------------
City | NEW YORK
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 10016-7584
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 212-759-2282
-----------------------------------------------------
Fax | 212-379-2123
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 3110 23RD ST APT 3B
-----------------------------------------------------
City | ASTORIA
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 11106-4586
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 609-412-4672
-----------------------------------------------------
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 | 041670
-----------------------------------------------------
License Number State | NY
-----------------------------------------------------