Provider Demographics
NPI:1467583435
Name:GEORGE GIOVANNONE PHYSICAL THERAPY P.C.
Entity Type:Organization
Organization Name:GEORGE GIOVANNONE PHYSICAL THERAPY P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:GEORGE
Authorized Official - Middle Name:
Authorized Official - Last Name:GIOVANNONE
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:845-344-1899
Mailing Address - Street 1:1219 DOLSONTOWN RD
Mailing Address - Street 2:
Mailing Address - City:MIDDLETOWN
Mailing Address - State:NY
Mailing Address - Zip Code:10940-4749
Mailing Address - Country:US
Mailing Address - Phone:845-344-1899
Mailing Address - Fax:845-344-1836
Practice Address - Street 1:1219 DOLSONTOWN RD
Practice Address - Street 2:
Practice Address - City:MIDDLETOWN
Practice Address - State:NY
Practice Address - Zip Code:10940-4749
Practice Address - Country:US
Practice Address - Phone:845-344-1899
Practice Address - Fax:845-344-1836
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-08
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY8512261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYQ56451Medicare UPIN