Provider Demographics
NPI:1639223936
Name:ORICCHIO, NICHOLAS F (RPT)
Entity Type:Individual
Prefix:MR
First Name:NICHOLAS
Middle Name:F
Last Name:ORICCHIO
Suffix:
Gender:M
Credentials:RPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11420 ROCKAWAY BLVD
Mailing Address - Street 2:
Mailing Address - City:SOUTH OZONE PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11420-1912
Mailing Address - Country:US
Mailing Address - Phone:718-845-4616
Mailing Address - Fax:718-845-1965
Practice Address - Street 1:11420 ROCKAWAY BLVD
Practice Address - Street 2:
Practice Address - City:SOUTH OZONE PARK
Practice Address - State:NY
Practice Address - Zip Code:11420-1912
Practice Address - Country:US
Practice Address - Phone:718-845-4616
Practice Address - Fax:718-845-1965
Is Sole Proprietor?:No
Enumeration Date:2007-01-23
Last Update Date:2008-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY5334225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00221GMedicare PIN