Basic Information
Provider Information
NPI: 1023417482
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: PINTO
FirstName: VITO
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: PT
OtherOrganizationName:  
OtherOrganizationType:  
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OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1536 3RD AVE
Address2:  
City: NEW YORK
State: NY
PostalCode: 100282167
CountryCode: US
TelephoneNumber: 2128612630
FaxNumber: 2128612685
Practice Location
Address1: 177 E 87TH ST
Address2: 303
City: NEW YORK
State: NY
PostalCode: 101282226
CountryCode: US
TelephoneNumber: 2128765300
FaxNumber: 2128765310
Other Information
ProviderEnumerationDate: 08/21/2014
LastUpdateDate: 11/26/2014
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
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AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
225100000X0378711NYY Respiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist 

No ID Information.


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