Provider Demographics
NPI:1033110838
Name:PAPALIA, JOHN H (PT)
Entity Type:Individual
Prefix:MR
First Name:JOHN
Middle Name:H
Last Name:PAPALIA
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:209 MERRICK AVE
Mailing Address - Street 2:
Mailing Address - City:MERRICK
Mailing Address - State:NY
Mailing Address - Zip Code:11566-3125
Mailing Address - Country:US
Mailing Address - Phone:516-867-0500
Mailing Address - Fax:516-623-1296
Practice Address - Street 1:209 MERRICK AVE
Practice Address - Street 2:
Practice Address - City:MERRICK
Practice Address - State:NY
Practice Address - Zip Code:11566-3125
Practice Address - Country:US
Practice Address - Phone:516-867-0500
Practice Address - Fax:516-623-1296
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-08-03
Last Update Date:2007-07-08
Deactivation Date:2006-03-21
Deactivation Code:
Reactivation Date:2006-03-27
Provider Licenses
StateLicense IDTaxonomies
NY004959225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYQ51651Medicare ID - Type Unspecified