Provider Demographics
NPI:1124746094
Name:DEL FIERRO, MARY DANE L (PT)
Entity type:Individual
Prefix:MS
First Name:MARY DANE
Middle Name:L
Last Name:DEL FIERRO
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:3754 65TH ST FL 2
Mailing Address - Street 2:
Mailing Address - City:WOODSIDE
Mailing Address - State:NY
Mailing Address - Zip Code:11377-2849
Mailing Address - Country:US
Mailing Address - Phone:332-217-7575
Mailing Address - Fax:
Practice Address - Street 1:1963 GRAND CONCOURSE FL 2
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10453-4995
Practice Address - Country:US
Practice Address - Phone:718-466-4600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-08-17
Last Update Date:2022-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
04793201225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist