Basic Information
Provider Information
NPI: 1720504327
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: CINOTTI
FirstName: ERICK
MiddleName: A
NamePrefix:  
NameSuffix:  
Credential: PT, DPT
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1377 MOTOR PKWY
Address2: STE 307
City: ISLANDIA
State: NY
PostalCode: 117495258
CountryCode: US
TelephoneNumber: 6315805200
FaxNumber: 6317608306
Practice Location
Address1: 66 SUNSET STRIP STE 400
Address2:  
City: SUCCASUNNA
State: NJ
PostalCode: 078761362
CountryCode: US
TelephoneNumber: 9735843191
FaxNumber: 9735843194
Other Information
ProviderEnumerationDate: 08/16/2017
LastUpdateDate: 04/09/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 04/09/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
225100000X  N Respiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist 
225100000XPT5001MEN Respiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist 
225100000X40QA01804500NJY Respiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist 

No ID Information.


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