NPIMap

Organization Active NPI

Mauro-Bertolo Therapy SVCS PTPC

  • Physical Therapist
  • Cicero, NY
National Provider Identifier
1962494930
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
MAURO-BERTOLO THERAPY SVCS PTPC
Practice address
6221 Rte 31
Ste 103
Cicero, NY 13039
Phone
(315) 699-1009
Fax
(315) 699-1094
NPI assigned
Aug 16, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mary Mauro Bertolo, PT
Title
Owner/President
Phone
(315) 699-1009

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 225100000X Primary

Addresses

Primary practice location

6221 Rte 31
Ste 103
Cicero, NY 13039

Mailing address

6221 Rte 31
Ste 103
Cicero, NY 13039
Phone (315) 699-1009

National Provider Directory

National Provider Directory

Locations

6221 State Route 31
Ste 103
Cicero, NY 13039
Phone (315) 699-1009

475 Irving Ave
Ste 94
Syracuse, NY 13210
Phone (315) 234-9609

Practitioners & affiliated clinicians

Practitioners 18

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 18

NPI Registry JSON

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

{
    "created_epoch": "1124150400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1962494930",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6221 RTE 31",
            "address_2": "STE 103",
            "city": "CICERO",
            "state": "NY",
            "postal_code": "13039",
            "telephone_number": "315-699-1009",
            "fax_number": "315-699-1094"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6221 RTE 31",
            "address_2": "STE 103",
            "city": "CICERO",
            "state": "NY",
            "postal_code": "13039",
            "telephone_number": "315-699-1009",
            "fax_number": "315-699-1094"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAURO-BERTOLO THERAPY SVCS PTPC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-08-16",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MAURO BERTOLO",
        "authorized_official_first_name": "MARY",
        "authorized_official_title_or_position": "OWNER/PRESIDENT",
        "authorized_official_telephone_number": "315-699-1009",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cicero, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.