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NPI Code Detail

MEDICARE: LUKE BONGIORNIO PT

MEDICARE:   LUKE  BONGIORNIO  PT
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
1225100000XPhysical Therapist018838-1NY

General Provider Information

NPI Number : 1144256504
Entity Type Code : Individual
Provider Name (Legal Business Name) : LUKE BONGIORNIO PT
Provider Business Mailing Address
First Line : 3636 33RD ST
Second Line :
City : ASTORIA
State : NY
Zip : 11106-2329
Country : US
Telephone Number : 718-707-6970
Fax Number : 718-707-6977
Provider Business Practice Location Address
First Line : 57 W 57TH ST STE 1406
Second Line :
City : NEW YORK
State : NY
Zip : 10019-2802
Country : US
Telephone Number : 212-399-3800
Fax Number : 212-399-3822
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/25/2006
Last Update Date : 03/06/2008

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Directions to “ LUKE BONGIORNIO PT” Practice Location

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