MEDICARE: MA JOANNA M ORMITA RPT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist	026067	NY

General Provider Information

NPI Number	:	1073781100
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MA JOANNA M ORMITA RPT

Provider Business Mailing Address
First Line	:	383 86TH ST
Second Line	:	APT 8
City	:	BROOKLYN
State	:	NY
Zip	:	11209-5060
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	383 86TH ST
Second Line	:	APT 8
City	:	BROOKLYN
State	:	NY
Zip	:	11209-5013
Country	:	US
Telephone Number	:	646-691-7956
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/12/2008
Last Update Date	:	02/14/2008

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