Provider Demographics
NPI:1568582435
Name:FORGIONE, JOHN J (PT)
Entity Type:Individual
Prefix:MR
First Name:JOHN
Middle Name:J
Last Name:FORGIONE
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 1:321 REGENT DR
Mailing Address - Street 2:
Mailing Address - City:LITITZ
Mailing Address - State:PA
Mailing Address - Zip Code:17543-8303
Mailing Address - Country:US
Mailing Address - Phone:717-368-0227
Mailing Address - Fax:717-625-2607
Practice Address - Street 1:321 REGENT DR
Practice Address - Street 2:
Practice Address - City:LITITZ
Practice Address - State:PA
Practice Address - Zip Code:17543-8303
Practice Address - Country:US
Practice Address - Phone:717-368-0227
Practice Address - Fax:717-625-2607
Is Sole Proprietor?:No
Enumeration Date:2007-04-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT016889225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ068961Medicare ID - Type Unspecified
PA083534Medicare ID - Type Unspecified