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NPI Code Detail

MEDICARE: MS. MARY DANE L DEL FIERRO PT

MEDICARE: MS. MARY DANE L DEL FIERRO PT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225100000XPhysical Therapist04793201

General Provider Information

NPI Number : 1124746094
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. MARY DANE L DEL FIERRO PT
Provider Business Mailing Address
First Line : 3754 65TH ST FL 2
Second Line :
City : WOODSIDE
State : NY
Zip : 11377-2849
Country : US
Telephone Number : 332-217-7575
Fax Number :
Provider Business Practice Location Address
First Line : 1963 GRAND CONCOURSE FL 2
Second Line :
City : BRONX
State : NY
Zip : 10453-4995
Country : US
Telephone Number : 718-466-4600
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/17/2022
Last Update Date : 08/21/2022

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