Provider Demographics
NPI:1770255655
Name:PADIOS, VINCE RIAN T (PT)
Entity Type:Individual
Prefix:
First Name:VINCE
Middle Name:RIAN T
Last Name:PADIOS
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 1:1255 5TH AVE APT 6L
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10029-3996
Mailing Address - Country:US
Mailing Address - Phone:914-400-1500
Mailing Address - Fax:914-478-8781
Practice Address - Street 1:1 HANSON PL
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11243-2900
Practice Address - Country:US
Practice Address - Phone:718-857-1900
Practice Address - Fax:718-857-1900
Is Sole Proprietor?:Yes
Enumeration Date:2021-09-29
Last Update Date:2021-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY047745-01225100000X
225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist