Anthony J Petrucci, P.T.

Primary specialty

Physical Therapy Clinic/CenterTaxonomy code 261QP2000X

License

021694 Issued in NY

Practice address

235 North Ave
Penn Yan, NY 14527-1051

Phone

(315) 536-7447

NPI assigned

May 31, 2016

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

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

{
    "created_epoch": "1464652800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1464652800000",
    "number": "1508214537",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "250 WASHINGTON ST",
            "city": "GENEVA",
            "state": "NY",
            "postal_code": "144562708",
            "telephone_number": "315-745-9438"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "235 NORTH AVE",
            "city": "PENN YAN",
            "state": "NY",
            "postal_code": "145271051",
            "telephone_number": "315-536-7447"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETRUCCI",
        "first_name": "ANTHONY",
        "middle_name": "J",
        "credential": "P.T.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-05-31",
        "last_updated": "2016-05-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "NY",
            "license": "021694",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Penn Yan Area Volunteer Ambulance Corps Inc
• Penn Yan Central School
• Penn Yan Manor Nursing Home, Inc.
• Penn Yan Optometry PC
• Penn Yan Physical Therapy P.C.
• Danielle Pfeiffer, LMSW
• Ross Spencer Phippen Jr., DMD
• Maddison P Pickering, OTR/L
• Joshua Pritchard, OTR/L
• Shannon Proctor, NP

• Physical Therapy Clinic/Center in Penn Yan, NY
• Providers in Penn Yan, NY by specialty
• Physical Therapy Clinic/Center in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 31, 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.

Verify at the official NPI Registry.