Organization
CORE PHYSICAL THERAPY & SPORT REHABILITATION PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MARK ANTHONY PACCHIANO PT/DPT (OWNER)
(719) 356-2919
Entity
Organization
Contact information
Practice address
259 JEFFERSON BLVD, STATEN ISLAND, NY 10312-3001
(718) 356-2919
Mailing address
259 JEFFERSON BLVD, STATEN ISLAND, NY 10312-3001
(718) 356-2919
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
021520-1
NY
Other
Enumeration date
03/13/2007
Last updated
02/23/2024
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