Provider Demographics
NPI:1417081449
Name:COCIFFI-POINTDUJOUR, REGINALD (PT, DPT)
Entity Type:Individual
Prefix:DR
First Name:REGINALD
Middle Name:
Last Name:COCIFFI-POINTDUJOUR
Suffix:
Gender:M
Credentials:PT, DPT
Other - Prefix:DR
Other - First Name:REGINALD
Other - Middle Name:
Other - Last Name:POINTDUJOUR
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PT, DPT
Mailing Address - Street 1:3215 OVERLAND AVE APT 8176
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90034-4546
Mailing Address - Country:US
Mailing Address - Phone:323-300-4198
Mailing Address - Fax:
Practice Address - Street 1:3215 OVERLAND AVE APT 8176
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90034-4546
Practice Address - Country:US
Practice Address - Phone:323-300-4198
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-14
Last Update Date:2022-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY029143225100000X
CA350532251N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2251N0400XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistNeurologyGroup - Single Specialty
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYQAW561Medicare ID - Type Unspecified