Provider Demographics
NPI:1447714498
Name:DIIORIO, RALPH ANTHONY (PT / ATC)
Entity type:Individual
Prefix:MR
First Name:RALPH
Middle Name:ANTHONY
Last Name:DIIORIO
Suffix:
Gender:M
Credentials:PT / ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:204 SENECA BLVD
Mailing Address - Street 2:
Mailing Address - City:BARNEGAT
Mailing Address - State:NJ
Mailing Address - Zip Code:08005-2801
Mailing Address - Country:US
Mailing Address - Phone:908-591-2926
Mailing Address - Fax:
Practice Address - Street 1:OLD BRIDGE HIGH SCHOOL
Practice Address - Street 2:4209 HIGHWAY 516
Practice Address - City:MATAWAN
Practice Address - State:NJ
Practice Address - Zip Code:07747-0774
Practice Address - Country:US
Practice Address - Phone:732-290-3900
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-01-24
Last Update Date:2019-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MT000256002255A2300X
NJ40QA00620600261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer
No261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy