Provider Demographics
NPI:1538287917
Name:MAIO-THERAPY PHYSICAL THERAPY, PLLC
Entity Type:Organization
Organization Name:MAIO-THERAPY PHYSICAL THERAPY, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:VIRGINIA
Authorized Official - Middle Name:ANDREA
Authorized Official - Last Name:MAIORINO
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:917-797-0957
Mailing Address - Street 1:5800 ARLINGTON AVE
Mailing Address - Street 2:APT 1X
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10471-1402
Mailing Address - Country:US
Mailing Address - Phone:347-449-7396
Mailing Address - Fax:347-449-7396
Practice Address - Street 1:250 W 57TH ST
Practice Address - Street 2:SUITE 829
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10107-0001
Practice Address - Country:US
Practice Address - Phone:917-797-0957
Practice Address - Fax:212-459-1953
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-26
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY010819261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY1700890092OtherNPI TYPE I