Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 225100000X | Physical Therapist | 016320-1 | NY |
Y | 2251P0200X | Physical Therapist - Pediatrics | 016320 | NY |
NPI | 1013963735 |
---|---|
Provider Name | Peter Joseph Anello |
First Address | Newburgh, NY 12550-8781 |
Second Address | Newburgh, NY 12550-8781 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/05/2006 |
Last Update Date | 22/03/2011 |