Provider Demographics
NPI:1811721517
Name:DECARO, ARIANNA (PT,DPT)
Entity type:Individual
Prefix:
First Name:ARIANNA
Middle Name:
Last Name:DECARO
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 1:1080 ARDEN AVE BLDG SUITE
Mailing Address - Street 2:
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10312-3625
Mailing Address - Country:US
Mailing Address - Phone:718-356-9897
Mailing Address - Fax:
Practice Address - Street 1:1243 WOODROW RD
Practice Address - Street 2:
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10309-1725
Practice Address - Country:US
Practice Address - Phone:718-390-0060
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-08-27
Last Update Date:2024-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY053119225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist