MEDICARE: PRONET PHYSICAL THERAPY PC

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	016223	NY

General Provider Information

NPI Number	:	1316192677
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PRONET PHYSICAL THERAPY PC

Provider Business Mailing Address
First Line	:	1326 E 55TH ST
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11234-3326
Country	:	US
Telephone Number	:	917-821-6825
Fax Number	:	718-531-1059

Provider Business Practice Location Address
First Line	:	1326 E 55TH ST
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11234-3326
Country	:	US
Telephone Number	:	917-821-6825
Fax Number	:	718-531-1059

Authorized Official
Title or Position	:	OWNER
Name	:	MR. JOHN SALVATORE FRISCIA
Credential	:	PT
Telephone Number	:	917-821-6825

Provider Enumeration Date	:	11/29/2008
Last Update Date	:	11/29/2008

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