Provider Demographics
NPI:1548327117
Name:RINCON, JOHN PAUL (MS PT)
Entity type:Individual
Prefix:MR
First Name:JOHN PAUL
Middle Name:
Last Name:RINCON
Suffix:
Gender:M
Credentials:MS PT
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Mailing Address - Street 1:1452 CHAPIN AVENUE
Mailing Address - Street 2:
Mailing Address - City:MERRICK
Mailing Address - State:NY
Mailing Address - Zip Code:11566
Mailing Address - Country:US
Mailing Address - Phone:516-208-6140
Mailing Address - Fax:
Practice Address - Street 1:1229 WANTAGH AVENUE
Practice Address - Street 2:SUITE 104
Practice Address - City:WANTAGH
Practice Address - State:NY
Practice Address - Zip Code:11793
Practice Address - Country:US
Practice Address - Phone:516-785-5257
Practice Address - Fax:516-785-5154
Is Sole Proprietor?:No
Enumeration Date:2007-01-03
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY02236012251P0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYQ09X41OtherBCBS PPO EPO
NYA745513OtherOXFORD