Provider Demographics
NPI:1477148161
Name:SPIRITO, JOHN (PT, DPT)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:
Last Name:SPIRITO
Suffix:
Gender:M
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:178 LAKEVIEW AVE
Mailing Address - Street 2:
Mailing Address - City:CLIFTON
Mailing Address - State:NJ
Mailing Address - Zip Code:07011-4071
Mailing Address - Country:US
Mailing Address - Phone:973-998-8828
Mailing Address - Fax:
Practice Address - Street 1:81 FORT SALONGA RD STE C
Practice Address - Street 2:
Practice Address - City:NORTHPORT
Practice Address - State:NY
Practice Address - Zip Code:11768-2889
Practice Address - Country:US
Practice Address - Phone:631-380-3820
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-03-04
Last Update Date:2023-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA01995900225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist