Provider Demographics
NPI:1457419434
Name:FRISCIA, JOHN SALVATORE (PT)
Entity Type:Individual
Prefix:MR
First Name:JOHN
Middle Name:SALVATORE
Last Name:FRISCIA
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1326 E 55TH ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11234-3326
Mailing Address - Country:US
Mailing Address - Phone:718-531-1059
Mailing Address - Fax:718-531-1059
Practice Address - Street 1:5607 AVENUE L
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11234-3317
Practice Address - Country:US
Practice Address - Phone:718-258-6100
Practice Address - Fax:718-692-0661
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY016223225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY000000107489OtherGHI HOM PROV NUMBER
NY5C7078OtherORTHONET HEALTH NET
NY6698683OtherGHI PROV NUMBER
NYFJ6223OtherMULTIPLAN ATLANTIS PROV
NY171523OtherELDER PLAN PROV NUMBER
NY2017438OtherUNITED HEALTH CARE NUMBER
NY64601OtherORTHONET CIGNA USFHP
NY016223OtherPT LICENSE NUMBER
NY1000041231OtherAFFINITY PROV NUMBER
NY178015OtherWELLCARE PROV NUMBER
NY1000041231OtherAFFINITY PROV NUMBER