Provider Demographics
NPI:1447479761
Name:ODIERNA, MARIA T (PT)
Entity type:Individual
Prefix:
First Name:MARIA
Middle Name:T
Last Name:ODIERNA
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:MARIA
Other - Middle Name:
Other - Last Name:MUENZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:24 APPALACHIAN W
Mailing Address - Street 2:
Mailing Address - City:HOPEWELL JCT
Mailing Address - State:NY
Mailing Address - Zip Code:12533-6711
Mailing Address - Country:US
Mailing Address - Phone:845-897-2387
Mailing Address - Fax:845-897-2387
Practice Address - Street 1:667 STONELEIGH AVE
Practice Address - Street 2:
Practice Address - City:CARMEL
Practice Address - State:NY
Practice Address - Zip Code:10512-2454
Practice Address - Country:US
Practice Address - Phone:845-279-4110
Practice Address - Fax:845-279-9432
Is Sole Proprietor?:No
Enumeration Date:2007-04-25
Last Update Date:2016-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY006626-1225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist