MEDICARE: MR. MASSIMO ROSARIO PULVIRENTI M.S.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
1	225100000X	Physical Therapist	033361	NY

General Provider Information

NPI Number	:	1184922932
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. MASSIMO ROSARIO PULVIRENTI M.S.PT

Provider Business Mailing Address
First Line	:	4 HEWITT AVE
Second Line	:
City	:	WHITE PLAINS
State	:	NY
Zip	:	10605-3906
Country	:	US
Telephone Number	:	914-946-0126
Fax Number	:	914-946-0126

Provider Business Practice Location Address
First Line	:	4 HEWITT AVE
Second Line	:
City	:	WHITE PLAINS
State	:	NY
Zip	:	10605-3906
Country	:	US
Telephone Number	:	914-946-0126
Fax Number	:	914-946-0126

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

Provider Enumeration Date	:	03/03/2011
Last Update Date	:	09/21/2021

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