Provider Demographics
NPI:1023314093
Name:ALL RIVERDALE PHYSICAL THERAPY, PC
Entity type:Organization
Organization Name:ALL RIVERDALE PHYSICAL THERAPY, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DIONISIO
Authorized Official - Middle Name:
Authorized Official - Last Name:MAURO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-884-8248
Mailing Address - Street 1:444 W 259TH ST APT 1
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10471-1622
Mailing Address - Country:US
Mailing Address - Phone:718-884-4260
Mailing Address - Fax:888-543-7447
Practice Address - Street 1:3424 KINGSBRIDGE AVE APT 1H
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10463-4002
Practice Address - Country:US
Practice Address - Phone:718-884-2460
Practice Address - Fax:888-543-7447
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-02-08
Last Update Date:2024-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY008557261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy