Provider Demographics
NPI:1023447174
Name:TURIANO, RALPH MICHAEL JR (PTA)
Entity type:Individual
Prefix:MR
First Name:RALPH
Middle Name:MICHAEL
Last Name:TURIANO
Suffix:JR
Gender:M
Credentials:PTA
Other - Prefix:MR
Other - First Name:R.
Other - Middle Name:MICHAEL
Other - Last Name:TURIANO
Other - Suffix:JR
Other - Last Name Type:Professional Name
Other - Credentials:PTA
Mailing Address - Street 1:117 WASHINGTON BLVD
Mailing Address - Street 2:
Mailing Address - City:BANGOR
Mailing Address - State:PA
Mailing Address - Zip Code:18013-2741
Mailing Address - Country:US
Mailing Address - Phone:814-207-7575
Mailing Address - Fax:
Practice Address - Street 1:701 SLATE BELT BLVD
Practice Address - Street 2:
Practice Address - City:BANGOR
Practice Address - State:PA
Practice Address - Zip Code:18013-9341
Practice Address - Country:US
Practice Address - Phone:610-599-1454
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-11-08
Last Update Date:2013-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PATEI000431225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
PATEI000431OtherPHYSICAL THERAPIST ASSISTANT LICENSE