Provider Demographics
NPI:1952785669
Name:GRAVINO, JOSEPH P (PT, DPT)
Entity Type:Individual
Prefix:
First Name:JOSEPH
Middle Name:P
Last Name:GRAVINO
Suffix:
Gender:M
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2360 SWEET HOME RD STE 1-02
Mailing Address - Street 2:
Mailing Address - City:AMHERST
Mailing Address - State:NY
Mailing Address - Zip Code:14228-2329
Mailing Address - Country:US
Mailing Address - Phone:716-525-1184
Mailing Address - Fax:716-243-4721
Practice Address - Street 1:2360 SWEET HOME RD
Practice Address - Street 2:STE 1-02
Practice Address - City:AMHERST
Practice Address - State:NY
Practice Address - Zip Code:14228-2329
Practice Address - Country:US
Practice Address - Phone:716-525-1184
Practice Address - Fax:716-243-4721
Is Sole Proprietor?:Yes
Enumeration Date:2015-07-13
Last Update Date:2021-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy