Provider Demographics
NPI:1295283356
Name:GREGORIO, ALADINO J
Entity type:Individual
Prefix:
First Name:ALADINO
Middle Name:J
Last Name:GREGORIO
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 1:70 MAPLE AVE
Mailing Address - Street 2:
Mailing Address - City:ROCKVILLE CENTRE
Mailing Address - State:NY
Mailing Address - Zip Code:11570-4225
Mailing Address - Country:US
Mailing Address - Phone:516-639-0221
Mailing Address - Fax:516-608-6717
Practice Address - Street 1:70 MAPLE AVE
Practice Address - Street 2:
Practice Address - City:ROCKVILLE CENTRE
Practice Address - State:NY
Practice Address - Zip Code:11570-4225
Practice Address - Country:US
Practice Address - Phone:516-536-7388
Practice Address - Fax:516-608-6717
Is Sole Proprietor?:No
Enumeration Date:2016-09-19
Last Update Date:2016-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY040503225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist