Provider Demographics
NPI:1164504866
Name:PARISI, MICHAEL C (PT)
Entity Type:Individual
Prefix:MR
First Name:MICHAEL
Middle Name:C
Last Name:PARISI
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 1:5 MAIN ST STE 6
Mailing Address - Street 2:
Mailing Address - City:QUEENSBURY
Mailing Address - State:NY
Mailing Address - Zip Code:12804-4067
Mailing Address - Country:US
Mailing Address - Phone:518-798-2225
Mailing Address - Fax:518-798-2807
Practice Address - Street 1:5 MAIN ST STE 6
Practice Address - Street 2:
Practice Address - City:QUEENSBURY
Practice Address - State:NY
Practice Address - Zip Code:12804-4067
Practice Address - Country:US
Practice Address - Phone:518-798-2225
Practice Address - Fax:518-798-2807
Is Sole Proprietor?:No
Enumeration Date:2006-10-20
Last Update Date:2023-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0253741225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist