Provider Demographics
NPI:1235184565
Name:PETER J ANELLO PT PC
Entity Type:Organization
Organization Name:PETER J ANELLO PT PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:PETER
Authorized Official - Middle Name:J
Authorized Official - Last Name:ANELLO
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:845-562-1054
Mailing Address - Street 1:28 WILLETS WAY
Mailing Address - Street 2:
Mailing Address - City:NEWBURGH
Mailing Address - State:NY
Mailing Address - Zip Code:12550-8781
Mailing Address - Country:US
Mailing Address - Phone:845-562-1054
Mailing Address - Fax:845-562-6148
Practice Address - Street 1:28 WILLETS WAY
Practice Address - Street 2:
Practice Address - City:NEWBURGH
Practice Address - State:NY
Practice Address - Zip Code:12550-8781
Practice Address - Country:US
Practice Address - Phone:845-562-1054
Practice Address - Fax:845-562-6148
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-24
Last Update Date:2011-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYQ3W4F1Medicare ID - Type Unspecified