Anthony Derrico Sr.
Individual provider Active NPI Physical Therapy Assistant · Cohoes, NY
NPI 1609270669 · NPPES record last updated Oct 20, 2014
Key facts
- NPI
- 1609270669
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapy Assistant 225200000X
- License
- 003212-1 (NY)
- Practice address
- 20 Summit Street
Cohoes, NY 12047 - Phone
- (518) 486-9024
- NPI assigned
- Oct 20, 2014
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 003212-1 | NY | MD | Pediatric Occupational Therapist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapy Assistant | 225200000X | 003212-1 | NY | Yes |
Addresses
Primary practice location
20 Summit Street
Cohoes, NY 12047
Mailing address
20 Summit St
Cohoes, NY 12047-2516
Phone (518) 486-9024
Other providers in Cohoes, NY
- Elisabeth Sara Davis
- Ingrid Davis
- Cynthia Marie Dawkins
- Julie Ann Debortoli
- Angel Marie Derepentigny-Pecak
- Colleen Ann Dillon
- Doc Z Family Practice PC
- Jennifer Anne Doesburg
- Deena M Dominy
- Chelsea Lyn Donnelly
All providers in Cohoes, NY · Physical Therapy Assistant in New York
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 20, 2014. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.