Basic Information
| Provider Information | |||||||||
| NPI: | 1801960562 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | PERCOCO | ||||||||
| FirstName: | ANTHONY | ||||||||
| MiddleName: | CRAIG | ||||||||
| NamePrefix: | MR. | ||||||||
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| Credential: | MS PT | ||||||||
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| Mailing Information | |||||||||
| Address1: | 217 MAIN ST | ||||||||
| Address2: | |||||||||
| City: | ROWLEY | ||||||||
| State: | MA | ||||||||
| PostalCode: | 019691503 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9147635941 | ||||||||
| FaxNumber: | 9147635332 | ||||||||
| Practice Location | |||||||||
| Address1: | 217 MAIN ST | ||||||||
| Address2: | |||||||||
| City: | ROWLEY | ||||||||
| State: | MA | ||||||||
| PostalCode: | 019691503 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6177305337 | ||||||||
| FaxNumber: | 6177305461 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/17/2006 | ||||||||
| LastUpdateDate: | 05/04/2020 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 05/04/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225100000X | 0244071 | NY | N | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist | 208100000X | 11601 | MA | Y | Allopathic & Osteopathic Physicians | Physical Medicine & Rehabilitation |
No ID Information.