Provider Demographics
NPI:1285733394
Name:POLIMENI-NAPURANO, GEORGINE (PT)
Entity type:Individual
Prefix:
First Name:GEORGINE
Middle Name:
Last Name:POLIMENI-NAPURANO
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:GEORGINE
Other - Middle Name:
Other - Last Name:POLIMENI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:282 RAILROAD AVE
Mailing Address - Street 2:
Mailing Address - City:GREENWICH
Mailing Address - State:CT
Mailing Address - Zip Code:06830
Mailing Address - Country:US
Mailing Address - Phone:203-661-3444
Mailing Address - Fax:203-661-3729
Practice Address - Street 1:269 E MAIN ST
Practice Address - Street 2:
Practice Address - City:SMITHTOWN
Practice Address - State:NY
Practice Address - Zip Code:11787-2832
Practice Address - Country:US
Practice Address - Phone:631-863-1007
Practice Address - Fax:631-862-3668
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-22
Last Update Date:2019-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY015584225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYP00210202Medicare PIN