MEDICARE: JOHN DEMARCO

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
1	225100000X	Physical Therapist	PT019068	OH

General Provider Information

NPI Number	:	1285593269
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOHN DEMARCO

Provider Business Mailing Address
First Line	:	9075 STONEGATE CIR
Second Line	:
City	:	NORTH RIDGEVILLE
State	:	OH
Zip	:	44039-8954
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1730 W 25TH ST
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44113-3108
Country	:	US
Telephone Number	:	216-696-4300
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/16/2026
Last Update Date	:	01/16/2026

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