Provider Demographics
NPI:1770562258
Name:ERRIGO VITALE, TERESA (PT DPT OCS)
Entity type:Individual
Prefix:
First Name:TERESA
Middle Name:
Last Name:ERRIGO VITALE
Suffix:
Gender:F
Credentials:PT DPT OCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1300 FRANKLIN AVE STE LL2
Mailing Address - Street 2:
Mailing Address - City:GARDEN CITY
Mailing Address - State:NY
Mailing Address - Zip Code:11530-1760
Mailing Address - Country:US
Mailing Address - Phone:516-663-9099
Mailing Address - Fax:516-663-9092
Practice Address - Street 1:1300 FRANKLIN AVE STE LL2
Practice Address - Street 2:
Practice Address - City:GARDEN CITY
Practice Address - State:NY
Practice Address - Zip Code:11530-1760
Practice Address - Country:US
Practice Address - Phone:516-663-9099
Practice Address - Fax:516-663-9092
Is Sole Proprietor?:No
Enumeration Date:2006-01-12
Last Update Date:2010-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0089441225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
112657605OtherUS HEALTHCARE
112657605OtherMANAGED PHYSICAL NETWORK
112657605OtherORTHONET US FAMILY PLAN
NYP00364303OtherRR MEDICARE
NY106839000OtherDEPT OF LABOR
112657605OtherORTHONET CIGNA
112657605OtherBENEFIT PLAN ADMIN
008944OtherHIP
112657605OtherUNITED HEALTHCARE
112657605OtherBC OF CALIFORNIA
90754OtherAETNA
112657605OtherONE HEALTH PLAN
112657605OtherHERITAGE
112657605OtherCIGNA PPO
2C2669OtherHEALTHNET
112657605OtherMDNY
64142OtherVYTRA
64142OtherVYTRA