Provider Demographics
NPI:1528179306
Name:ORSINI, RICHARD P (PT)
Entity Type:Individual
Prefix:
First Name:RICHARD
Middle Name:P
Last Name:ORSINI
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 1:104 AMARON LN
Mailing Address - Street 2:
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10307-1963
Mailing Address - Country:US
Mailing Address - Phone:718-605-5532
Mailing Address - Fax:718-351-2269
Practice Address - Street 1:104 AMARON LN
Practice Address - Street 2:
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10307-1963
Practice Address - Country:US
Practice Address - Phone:718-605-5532
Practice Address - Fax:718-351-2269
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-31
Last Update Date:2007-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0144781261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYQ10082Medicare PIN