| Doctor Name: | LAWRENCE TRAVAGLIA |
| NPI Number: | 1053709923 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | |
| License Number: | 40QA01584600 |
| Business Practice Address: | 300 Route 17 Mahwah, NJ - 074302141 |
| Business Phone Number: | 2015298322 |
| Business Fax Number: | 2015298377 |
| Mailing Address: | 333 Earle Ovington Blvd, Suite 225 UNIONDALE |
| State: | NY |
| Postal Code: | 115533610 |
| Phone Number: | 5163212424 |
| Fax Number: | 5163212424 |
| NPI Enumeration Date: | 12/31/2014 |
| NPI Last Update Date: | 12/31/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 225100000X |
| License Number: | 40QA01584600 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NJ |
| Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Taxonomy Classification: | Physical Therapist |
| Taxonomy Specialization: | |
| Taxonomy Definition: | (1) Physical therapists are health care professionals who evaluate and treat people with health problems resulting from injury or disease. PT |