Provider Demographics
NPI:1548535016
Name:TOLENTINO, WARREN (PT)
Entity type:Individual
Prefix:MR
First Name:WARREN
Middle Name:
Last Name:TOLENTINO
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:721 CRICKET LN
Mailing Address - Street 2:
Mailing Address - City:WOODBRIDGE
Mailing Address - State:NJ
Mailing Address - Zip Code:07095-1557
Mailing Address - Country:US
Mailing Address - Phone:732-750-2798
Mailing Address - Fax:
Practice Address - Street 1:370 MARCY AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11206-4814
Practice Address - Country:US
Practice Address - Phone:718-388-4800
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-03-17
Last Update Date:2012-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY023744225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist