Provider Demographics
NPI:1679714034
Name:PIEGARO, ANTHONY B JR (ATC)
Entity type:Individual
Prefix:
First Name:ANTHONY
Middle Name:B
Last Name:PIEGARO
Suffix:JR
Gender:M
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23 CALUMET ST
Mailing Address - Street 2:
Mailing Address - City:NEWARK
Mailing Address - State:NJ
Mailing Address - Zip Code:07105-1505
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3030 BROADWAY
Practice Address - Street 2:MAIL CODE 1915
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10027-6907
Practice Address - Country:US
Practice Address - Phone:212-854-3178
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-03-16
Last Update Date:2009-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer