Provider Demographics
NPI:1811081672
Name:PISHIONERI, MICHAEL JOSEPH (PT)
Entity type:Individual
Prefix:MR
First Name:MICHAEL
Middle Name:JOSEPH
Last Name:PISHIONERI
Suffix:
Gender:M
Credentials:PT
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Mailing Address - Street 1:1744 EDGESTONE CT
Mailing Address - Street 2:
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23453
Mailing Address - Country:US
Mailing Address - Phone:757-943-1428
Mailing Address - Fax:
Practice Address - Street 1:6330 NEWTOWN RD
Practice Address - Street 2:SUITE 109 ATLANTIC PHYSICAL THERAPY
Practice Address - City:NORFOLK
Practice Address - State:VA
Practice Address - Zip Code:23502
Practice Address - Country:US
Practice Address - Phone:757-466-4401
Practice Address - Fax:757-466-4404
Is Sole Proprietor?:No
Enumeration Date:2006-10-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
VA23052034532251S0007X, 2251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered2251S0007XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistSports
Not Answered2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA2108673OtherMAMS
VA002197A04Medicare ID - Type Unspecified