John Edward Petrizzo, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

035461-1

Practice address

1482 Northern Blvd
Excel Physical Therapy & Sports Rehabilitation
Manhasset, NY 11030-3006

Phone

(516) 627-3009

Fax

(506) 627-8424

NPI assigned

Feb 26, 2013

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1361836800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1361836800000",
    "number": "1083954168",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17 FROST POND RD",
            "city": "GLEN COVE",
            "state": "NY",
            "postal_code": "115423932",
            "telephone_number": "516-661-6674"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1482 NORTHERN BLVD",
            "address_2": "EXCEL PHYSICAL THERAPY & SPORTS REHABILITATION",
            "city": "MANHASSET",
            "state": "NY",
            "postal_code": "110303006",
            "telephone_number": "516-627-3009",
            "fax_number": "506-627-8424"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETRIZZO",
        "first_name": "JOHN",
        "middle_name": "EDWARD",
        "name_prefix": "Mr.",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-02-26",
        "last_updated": "2013-02-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": "035461-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Marissa Linda-Kaye Persaud, NURSE PRACTITIONER
• Diana Marie Pertoso
• Caroline Pessel, M.D.
• Peter J Lacorte O.D. P.C.
• Colleen Petrere, PA-C
• Justin Michael Petrocelli, M.D.
• Jennifer Lauren Petrone, FNP-C
• Angelique Petropouleas, DO
• Jennifer Morgenstern Petruccelli
• Donald William Pettet III, DO

• Physical Therapist in Manhasset, NY
• Providers in Manhasset, NY by specialty
• Physical Therapist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 26, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.