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NPI Code Detail

MEDICARE: MRS. ALICE MARGARET HERRO PT

MEDICARE: MRS. ALICE MARGARET HERRO 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 Therapist5779NY

General Provider Information

NPI Number : 1871890350
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. ALICE MARGARET HERRO PT
Provider Business Mailing Address
First Line : 220 MAIN ST
Second Line : SUITE 3
City : CENTER MORICHES
State : NY
Zip : 11934-3516
Country : US
Telephone Number : 631-878-4545
Fax Number : 631-878-4573
Provider Business Practice Location Address
First Line : 220 MAIN ST
Second Line : SUITE 3
City : CENTER MORICHES
State : NY
Zip : 11934-3516
Country : US
Telephone Number : 631-878-4545
Fax Number : 631-878-4573
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/18/2011
Last Update Date : 02/18/2011

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