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General NPI Number Information
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NPI Number | 1659789824
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Entity Type | Organization
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Legal Business Name | PRNY, PC
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Dates
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Enumeration Date | 07/31/2014
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Last Update Date | 08/11/2015
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Provider Practice Location Address
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Address Line | 820 2ND AVE RM 7
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City | NEW YORK
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State | NY
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Zip | 10017-4528
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Country | US
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Telephone | 973-628-1300
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Fax | 973-628-0300
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Provider Business Mailing Address
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Address Line | 265 RTE 46 SUITE 102
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City | TOTOWA
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State | NJ
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Zip | 07512-1820
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Country | US
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Telephone | 973-628-1300
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Fax | 973-628-0300
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Authorized Official
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Title or Position | PRESIDENT
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Name | MRS. MARISSA M MUCCIO
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Credential | PT
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Telephone | 973-628-1300
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2000X
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Taxonomy Name | Physical Therapy Clinic/Center
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License Number | 037604-1
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License Number State | NY
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