Provider Demographics
NPI:1720628563
Name:PIRINO, JUSTIN WILLIAM (DPT)
Entity Type:Individual
Prefix:
First Name:JUSTIN
Middle Name:WILLIAM
Last Name:PIRINO
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:56 CROSS RD
Mailing Address - Street 2:
Mailing Address - City:COCHECTON
Mailing Address - State:NY
Mailing Address - Zip Code:12726-5004
Mailing Address - Country:US
Mailing Address - Phone:845-701-2690
Mailing Address - Fax:
Practice Address - Street 1:56 CROSS RD
Practice Address - Street 2:
Practice Address - City:COCHECTON
Practice Address - State:NY
Practice Address - Zip Code:12726-5004
Practice Address - Country:US
Practice Address - Phone:845-701-2690
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-01-09
Last Update Date:2020-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
045217225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist