Provider Demographics
NPI:1659895654
Name:ANNUZZI, ANGELO (PT, DPT)
Entity Type:Individual
Prefix:
First Name:ANGELO
Middle Name:
Last Name:ANNUZZI
Suffix:
Gender:M
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:450 N STATE RD
Mailing Address - Street 2:
Mailing Address - City:BRIARCLIFF MANOR
Mailing Address - State:NY
Mailing Address - Zip Code:10510-1451
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:450 N STATE RD
Practice Address - Street 2:
Practice Address - City:BRIARCLIFF MANOR
Practice Address - State:NY
Practice Address - Zip Code:10510-1451
Practice Address - Country:US
Practice Address - Phone:914-488-5763
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-08-01
Last Update Date:2023-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QB00339600225200000X
NY050172225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant