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Individual

MICHAEL MAGISTRO

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
ATC

Contact information

Practice address
125 TERRYVILLE RD, APT 8C, PORT JEFFERSON STATION, NY 11776-1300
(631) 974-2883
Mailing address
125 TERRYVILLE RD, APT 8C, PORT JEFFERSON STATION, NY 11776-1300

Taxonomy

Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
67002001
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1026686
NATIONAL ATHLETIC TRAINER ASSOCIATION
NY
Enumeration date
01/25/2012
Last updated
01/25/2012
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