Provider Demographics
NPI:1871787911
Name:CHIABO, MARCO ANTONIO (DPT,COMT,BS,CSCS)
Entity type:Individual
Prefix:DR
First Name:MARCO
Middle Name:ANTONIO
Last Name:CHIABO
Suffix:
Gender:M
Credentials:DPT,COMT,BS,CSCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1244
Mailing Address - Street 2:
Mailing Address - City:CUTCHOGUE
Mailing Address - State:NY
Mailing Address - Zip Code:11935-0883
Mailing Address - Country:US
Mailing Address - Phone:631-298-5367
Mailing Address - Fax:631-298-3810
Practice Address - Street 1:17 E 13TH ST
Practice Address - Street 2:AUSTRALIAN PHYSIOTHERAPY
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10003-4480
Practice Address - Country:US
Practice Address - Phone:212-691-6303
Practice Address - Fax:212-691-6306
Is Sole Proprietor?:No
Enumeration Date:2007-08-31
Last Update Date:2010-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY029622225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist