MEDICARE: JOHN COGNATO PT 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

General Provider Information

NPI Number	:	1447342803
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JOHN COGNATO PT PC

Provider Business Mailing Address
First Line	:	1001 W FAYETTE ST
Second Line	:	SUITE 400
City	:	SYRACUSE
State	:	NY
Zip	:	13204-2859
Country	:	US
Telephone Number	:	315-472-1488
Fax Number	:	315-472-8060

Provider Business Practice Location Address
First Line	:	505 NYS ROUTE 281
Second Line	:
City	:	TULLY
State	:	NY
Zip	:	13159
Country	:	US
Telephone Number	:	315-696-2400
Fax Number	:	315-696-2486

Authorized Official
Title or Position	:	OWNER
Name	:	JOHN COGNATO
Credential	:	PT
Telephone Number	:	315-696-2400

Provider Enumeration Date	:	09/29/2006
Last Update Date	:	03/20/2013

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