Provider Demographics
NPI:1801013412
Name:ARIRIERI, EDWARD
Entity Type:Individual
Prefix:MR
First Name:EDWARD
Middle Name:
Last Name:ARIRIERI
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10257 TREVINO ST
Mailing Address - Street 2:
Mailing Address - City:CROWN POINT
Mailing Address - State:IN
Mailing Address - Zip Code:46307-6514
Mailing Address - Country:US
Mailing Address - Phone:219-310-8247
Mailing Address - Fax:219-354-8523
Practice Address - Street 1:6735 JEFFERSON ST
Practice Address - Street 2:
Practice Address - City:MERRILLVILLE
Practice Address - State:IN
Practice Address - Zip Code:46410-3408
Practice Address - Country:US
Practice Address - Phone:219-736-8241
Practice Address - Fax:219-736-5487
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-18
Last Update Date:2016-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN05003855A225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200724560AOtherPROVIDER ID