Provider Demographics
NPI:1144612524
Name:TERRIGNO, ANTHONY (PT, DPT)
Entity Type:Individual
Prefix:
First Name:ANTHONY
Middle Name:
Last Name:TERRIGNO
Suffix:
Gender:M
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:201 SAINT PAULS AVE APT 3S
Mailing Address - Street 2:
Mailing Address - City:JERSEY CITY
Mailing Address - State:NJ
Mailing Address - Zip Code:07306-3752
Mailing Address - Country:US
Mailing Address - Phone:201-615-2145
Mailing Address - Fax:
Practice Address - Street 1:201 SAINT PAULS AVE APT 3S
Practice Address - Street 2:
Practice Address - City:JERSEY CITY
Practice Address - State:NJ
Practice Address - Zip Code:07306-3752
Practice Address - Country:US
Practice Address - Phone:201-615-2145
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-02-23
Last Update Date:2015-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA01562800225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist