Basic Information
| Provider Information | |||||||||
| NPI: | 1699846022 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | D AGOSTINO | ||||||||
| FirstName: | FRANK | ||||||||
| MiddleName: | A | ||||||||
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| Credential: | PT | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2316 PINE AVE | ||||||||
| Address2: | ACCESS PHYSICAL THERAPY | ||||||||
| City: | NIAGARA FALLS | ||||||||
| State: | NY | ||||||||
| PostalCode: | 143012338 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7162844474 | ||||||||
| FaxNumber: | 7162844844 | ||||||||
| Practice Location | |||||||||
| Address1: | 2316 PINE AVE | ||||||||
| Address2: | ACCESS PHYSICAL THERAPY | ||||||||
| City: | NIAGARA FALLS | ||||||||
| State: | NY | ||||||||
| PostalCode: | 143012338 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7162844474 | ||||||||
| FaxNumber: | 7162844844 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/09/2006 | ||||||||
| LastUpdateDate: | 10/26/2007 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225100000X | 0170751 | NY | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist |
ID Information
| ID | Type | State | Issuer | Description | 000528779001 | 01 | NY | BCBS WNY | OTHER | 9314139 | 01 | NY | IHA | OTHER |