Active NPI
Justin Petrozzini, DPT
- Physical Therapist
- Philadelphia, PA
National Provider Identifier
1154771301
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PT025456
- Practice address
- 3400 Aramingo Ave
Suite 11
Philadelphia, PA 19134-4513 - Phone
- (215) 203-1930
- Fax
- (215) 203-1931
- NPI assigned
- Jun 20, 2016
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | PT025456 | PA | Primary |
Addresses
Primary practice location
3400 Aramingo Ave
Suite 11
Philadelphia, PA 19134-4513
Mailing address
1111 Bainbridge St
Philadelphia, PA 19147-1905
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1466380800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1470182400000",
"number": "1154771301",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1111 BAINBRIDGE ST",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "191471905"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3400 ARAMINGO AVE",
"address_2": "SUITE 11",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "191344513",
"telephone_number": "215-203-1930",
"fax_number": "215-203-1931"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PETROZZINI",
"first_name": "JUSTIN",
"credential": "DPT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2016-06-20",
"last_updated": "2016-08-03",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "PA",
"license": "PT025456",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Philadelphia, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 3, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.