Provider Demographics
NPI:1972688018
Name:MAURO, DIONISIO B JR (PT)
Entity type:Individual
Prefix:MR
First Name:DIONISIO
Middle Name:B
Last Name:MAURO
Suffix:JR
Gender:M
Credentials:PT
Other - Prefix:
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Mailing Address - Street 1:381 5TH ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11215-2806
Mailing Address - Country:US
Mailing Address - Phone:718-852-5252
Mailing Address - Fax:718-802-1113
Practice Address - Street 1:332 DEKALB AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11205-3820
Practice Address - Country:US
Practice Address - Phone:718-852-5252
Practice Address - Fax:718-802-1113
Is Sole Proprietor?:No
Enumeration Date:2006-10-26
Last Update Date:2008-03-10
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NYNY0085571225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYQ64042Medicare ID - Type Unspecified