Active NPI
Patricia Procino
- Physical Therapist
- Lodi, NJ
National Provider Identifier
1578959664
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 40QA00297300
- Practice address
- 260 S Main St
Lodi, NJ 07644-2117 - Phone
- (973) 472-2080
- NPI assigned
- Apr 15, 2015
- Sex
- Female
- 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 | 40QA00297300 | NJ | Primary |
Addresses
Primary practice location
260 S Main St
Lodi, NJ 07644-2117
Mailing address
401 Ridge Rd
Suite 1
Dayton, NJ 08810-3300
Phone (732) 230-3076
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 40QA00297300 | NJ | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Imperial Vista Health Care Staffing, LLC | Physical Therapist | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Occupational Therapist
- Lodi, NJ
- NPI 1003211152
Physical Therapist
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1429056000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1429056000000",
"number": "1578959664",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "401 RIDGE RD",
"address_2": "SUITE 1",
"city": "DAYTON",
"state": "NJ",
"postal_code": "088103300",
"telephone_number": "732-230-3076",
"fax_number": "732-230-3079"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "260 S MAIN ST",
"city": "LODI",
"state": "NJ",
"postal_code": "076442117",
"telephone_number": "973-472-2080"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PROCINO",
"first_name": "PATRICIA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-04-15",
"last_updated": "2015-04-15",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "NJ",
"license": "40QA00297300",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lodi, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.