Individual ProviderMark Anthony PacchianoPhysical TherapistRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPractice Address259 Jefferson Blvd, Staten Island, NY 10312-3001(718) 356-2919PECOS EnrollmentBased on the most recent information from CMS, provider Mark Anthony Pacchiano does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records 34 days ago.Profile DetailsProvider ID1104986223Provider TypeIndividualFull NamePacchiano, Mark AnthonyTitleMr.CredentialMSPT, MTC, CSCSGenderMaleSole ProprietorYesEnumeration Date12/11/2006Last Updated6/22/2021Contact InformationPractice LocationPractice Address259 Jefferson Blvd, Staten Island, NY 10312-3001Phone(718) 356-2919Fax(718) 356-6015Mailing LocationMailing Address259 Jefferson Blvd, Staten Island, NY 10312-3001Phone(718) 356-2919Fax(718) 356-6015Provider TaxonomiesCodeDescriptionLicenseCode225100000XPrimaryDescriptionPhysical TherapistRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersLicense021520-1New York