Provider Demographics
NPI:1386446474
Name:DELGAIZO, MARCUS (DPT)
Entity type:Individual
Prefix:
First Name:MARCUS
Middle Name:
Last Name:DELGAIZO
Suffix:
Gender:
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7 WASHINGTON ST STE A100
Mailing Address - Street 2:
Mailing Address - City:CHURCHVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:14428-9603
Mailing Address - Country:US
Mailing Address - Phone:585-293-9160
Mailing Address - Fax:585-293-9175
Practice Address - Street 1:7 WASHINGTON ST STE A100
Practice Address - Street 2:
Practice Address - City:CHURCHVILLE
Practice Address - State:NY
Practice Address - Zip Code:14428-9603
Practice Address - Country:US
Practice Address - Phone:585-293-9160
Practice Address - Fax:585-293-9175
Is Sole Proprietor?:No
Enumeration Date:2025-03-27
Last Update Date:2025-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY054093225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist