Provider Demographics
NPI:1548692874
Name:PANZARELLA PHYSICAL THERAPY P.C.
Entity type:Organization
Organization Name:PANZARELLA PHYSICAL THERAPY P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JOANNE
Authorized Official - Middle Name:
Authorized Official - Last Name:PANZARELLA
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:585-248-0015
Mailing Address - Street 1:101 SULLYS TRL
Mailing Address - Street 2:BLDG 20, SUITE 9
Mailing Address - City:PITTSFORD
Mailing Address - State:NY
Mailing Address - Zip Code:14534-4552
Mailing Address - Country:US
Mailing Address - Phone:585-248-0015
Mailing Address - Fax:585-248-0019
Practice Address - Street 1:101 SULLYS TRL
Practice Address - Street 2:BLDG 20, SUITE 9
Practice Address - City:PITTSFORD
Practice Address - State:NY
Practice Address - Zip Code:14534-4552
Practice Address - Country:US
Practice Address - Phone:585-248-0015
Practice Address - Fax:585-248-0019
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-08-09
Last Update Date:2015-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0093111261QR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0400XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation