Provider Demographics
NPI:1134394802
Name:PESCE INC.
Entity type:Organization
Organization Name:PESCE INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:PHILIP
Authorized Official - Middle Name:SALVATORE
Authorized Official - Last Name:PESCE
Authorized Official - Suffix:
Authorized Official - Credentials:MS,PT
Authorized Official - Phone:718-701-0626
Mailing Address - Street 1:116 ROYAL OAK RD
Mailing Address - Street 2:
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10314-2519
Mailing Address - Country:US
Mailing Address - Phone:718-701-0626
Mailing Address - Fax:718-989-9234
Practice Address - Street 1:116 ROYAL OAK RD
Practice Address - Street 2:
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10314-2519
Practice Address - Country:US
Practice Address - Phone:718-701-0626
Practice Address - Fax:718-989-9234
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-24
Last Update Date:2008-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY018380-1225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty