Provider Demographics
NPI:1700890092
Name:MAIORINO, VIRGINIA ANDREA (PT)
Entity Type:Individual
Prefix:
First Name:VIRGINIA
Middle Name:ANDREA
Last Name:MAIORINO
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5800 ARLINGTON AVE
Mailing Address - Street 2:APT 1X
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10471-1402
Mailing Address - Country:US
Mailing Address - Phone:917-797-0957
Mailing Address - Fax:
Practice Address - Street 1:250 W 57TH ST
Practice Address - Street 2:SUITE 829
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10107-0001
Practice Address - Country:US
Practice Address - Phone:845-688-2888
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY010819225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist