Provider Demographics
NPI:1568453850
Name:SETTANNI, MICHAEL RICHARD (PT)
Entity Type:Individual
Prefix:MR
First Name:MICHAEL
Middle Name:RICHARD
Last Name:SETTANNI
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 1:2566 JERUSALEM AVE
Mailing Address - Street 2:
Mailing Address - City:N BELLMORE
Mailing Address - State:NY
Mailing Address - Zip Code:11710-1832
Mailing Address - Country:US
Mailing Address - Phone:516-785-1667
Mailing Address - Fax:516-785-1668
Practice Address - Street 1:2566 JERUSALEM AVE
Practice Address - Street 2:
Practice Address - City:N BELLMORE
Practice Address - State:NY
Practice Address - Zip Code:11710-1832
Practice Address - Country:US
Practice Address - Phone:516-785-1667
Practice Address - Fax:516-785-1668
Is Sole Proprietor?:No
Enumeration Date:2005-11-04
Last Update Date:2008-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0217571225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02325602Medicaid
NYQT1121OtherBC/BS
NYQT1121OtherBC/BS
NY02325602Medicaid