Michael Louis Scicchitano Sr., PT

Primary specialty

Geriatric Physical TherapistTaxonomy code 2251G0304X

License

019032 Issued in NY

Practice address

3 Colgate Street
Port Jefferson Station, NY 11776

Phone

(631) 457-9158

NPI assigned

Jun 22, 2017

Sex

Male

Sole proprietor

Yes

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

State licenses

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

{
    "created_epoch": "1498089600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1366962185",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3 COLGATE ST",
            "city": "PORT JEFFERSON STATION",
            "state": "NY",
            "postal_code": "117762803",
            "telephone_number": "631-457-9158"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3 COLGATE STREET",
            "city": "PORT JEFFERSON STATION",
            "state": "NY",
            "postal_code": "11776",
            "telephone_number": "631-457-9158"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCICCHITANO",
        "first_name": "MICHAEL",
        "middle_name": "LOUIS",
        "name_prefix": "Mr.",
        "name_suffix": "Sr.",
        "credential": "PT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-06-22",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251G0304X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Geriatrics",
            "state": "NY",
            "license": "019032",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kenneth A Schreiber, M.D.
• Philip Schulman, MD
• Brittney Lee Schuster, L.AC
• Michel Schwartz, NP
• Steven Schwartz, DDS, MD
• Lynn Scotti, MASSAGE THERAPIST
• Christine Scudero
• Sea Medical Wellness PC
• Diane Odessa Seaman, LCSW, BCD
• James A Seitz, LCSW

• Geriatric Physical Therapist in Port Jefferson Station, NY
• Providers in Port Jefferson Station, NY by specialty
• Geriatric Physical Therapist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.