Provider Demographics
NPI:1386295749
Name:MIANE, JOHN FLORENZ (PT)
Entity type:Individual
Prefix:
First Name:JOHN FLORENZ
Middle Name:
Last Name:MIANE
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16 MARTINO WAY
Mailing Address - Street 2:
Mailing Address - City:POMONA
Mailing Address - State:NY
Mailing Address - Zip Code:10970-2649
Mailing Address - Country:US
Mailing Address - Phone:845-364-6392
Mailing Address - Fax:
Practice Address - Street 1:42 RYKOWSKI LN
Practice Address - Street 2:
Practice Address - City:MIDDLETOWN
Practice Address - State:NY
Practice Address - Zip Code:10941-4018
Practice Address - Country:US
Practice Address - Phone:845-673-5554
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-09-26
Last Update Date:2019-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY044924-01225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist