MEDICARE: OLIVIA SARACENO PT,DPT

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	054858	NY

General Provider Information

NPI Number	:	1083590202
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	OLIVIA SARACENO PT,DPT

Provider Business Mailing Address
First Line	:	70 SAINT JAMES PL
Second Line	:
City	:	STATEN ISLAND
State	:	NY
Zip	:	10304-1264
Country	:	US
Telephone Number	:	917-524-4455
Fax Number	:

Provider Business Practice Location Address
First Line	:	150 GREAVES LN
Second Line	:
City	:	STATEN ISLAND
State	:	NY
Zip	:	10308-2114
Country	:	US
Telephone Number	:	718-715-1076
Fax Number	:

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

Provider Enumeration Date	:	08/13/2025
Last Update Date	:	08/13/2025

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