Provider Demographics
NPI:1730535477
Name:CESIRO, JOANNE (PT)
Entity type:Individual
Prefix:
First Name:JOANNE
Middle Name:
Last Name:CESIRO
Suffix:
Gender:F
Credentials:PT
Other - Prefix:DR
Other - First Name:JOANNE
Other - Middle Name:
Other - Last Name:CESIRO
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PT
Mailing Address - Street 1:655 BEEBE DR
Mailing Address - Street 2:
Mailing Address - City:CUTCHOGUE
Mailing Address - State:NY
Mailing Address - Zip Code:11935-2142
Mailing Address - Country:US
Mailing Address - Phone:631-987-7402
Mailing Address - Fax:
Practice Address - Street 1:201 MANOR PL
Practice Address - Street 2:
Practice Address - City:GREENPORT
Practice Address - State:NY
Practice Address - Zip Code:11944-1222
Practice Address - Country:US
Practice Address - Phone:631-765-9389
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-05-12
Last Update Date:2016-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY025519-1225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist