Provider Demographics
NPI:1235292236
Name:DIO, RICHARD LEO (PT)
Entity Type:Individual
Prefix:
First Name:RICHARD
Middle Name:LEO
Last Name:DIO
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 1:200 W CARVER ST
Mailing Address - Street 2:SUITE 4
Mailing Address - City:HUNTINGTON
Mailing Address - State:NY
Mailing Address - Zip Code:11743-3303
Mailing Address - Country:US
Mailing Address - Phone:631-385-1155
Mailing Address - Fax:631-385-0813
Practice Address - Street 1:200 W CARVER ST
Practice Address - Street 2:SUITE 4
Practice Address - City:HUNTINGTON
Practice Address - State:NY
Practice Address - Zip Code:11743-3303
Practice Address - Country:US
Practice Address - Phone:631-385-1155
Practice Address - Fax:631-385-0813
Is Sole Proprietor?:No
Enumeration Date:2006-12-19
Last Update Date:2008-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY025270-1225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist