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NPI Code Detail

MEDICARE: MR. VINCENT JOSEPH CAVALLARO P.T.

MEDICARE: MR. VINCENT JOSEPH CAVALLARO P.T.
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 Therapist0069911NY

General Provider Information

NPI Number : 1699848234
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. VINCENT JOSEPH CAVALLARO P.T.
Provider Business Mailing Address
First Line : 2345 BOYNTON PL
Second Line :
City : BROOKLYN
State : NY
Zip : 11223-4632
Country : US
Telephone Number : 718-996-1767
Fax Number : 718-232-5048
Provider Business Practice Location Address
First Line : 7608 15TH AVE
Second Line :
City : BROOKLYN
State : NY
Zip : 11228-2510
Country : US
Telephone Number : 718-259-0900
Fax Number : 718-232-5048
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/15/2006
Last Update Date : 10/14/2025

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