Provider Demographics
NPI:1962542811
Name:SAGINARIO, PETER ANTHONY (MSOTRL)
Entity type:Individual
Prefix:MR
First Name:PETER
Middle Name:ANTHONY
Last Name:SAGINARIO
Suffix:
Gender:M
Credentials:MSOTRL
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:252 N IOWA AVE
Mailing Address - Street 2:
Mailing Address - City:NORTH MASSAPEQUA
Mailing Address - State:NY
Mailing Address - Zip Code:11758-1335
Mailing Address - Country:US
Mailing Address - Phone:516-293-1995
Mailing Address - Fax:516-292-1995
Practice Address - Street 1:252 N IOWA AVE
Practice Address - Street 2:
Practice Address - City:NORTH MASSAPEQUA
Practice Address - State:NY
Practice Address - Zip Code:11758-1335
Practice Address - Country:US
Practice Address - Phone:516-293-1995
Practice Address - Fax:516-292-1995
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0115301225X00000X, 225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Not Answered225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics