Provider Demographics
NPI:1427458397
Name:PICORARO, ASHLEY D (PT, DPT)
Entity type:Individual
Prefix:
First Name:ASHLEY
Middle Name:D
Last Name:PICORARO
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:120 TARGETT RD
Mailing Address - Street 2:
Mailing Address - City:NEW GLOUCESTER
Mailing Address - State:ME
Mailing Address - Zip Code:04260-4257
Mailing Address - Country:US
Mailing Address - Phone:207-200-1954
Mailing Address - Fax:
Practice Address - Street 1:120 TARGETT RD
Practice Address - Street 2:
Practice Address - City:NEW GLOUCESTER
Practice Address - State:ME
Practice Address - Zip Code:04260-4257
Practice Address - Country:US
Practice Address - Phone:207-200-1954
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-08-28
Last Update Date:2021-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT040.0110542225100000X
MEPT4298225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist