Provider Demographics
NPI:1871062406
Name:GAETANO, DELANEY RYANNE (PT, DPT)
Entity type:Individual
Prefix:
First Name:DELANEY
Middle Name:RYANNE
Last Name:GAETANO
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 1:439 LEWISTON RD
Mailing Address - Street 2:
Mailing Address - City:TOPSHAM
Mailing Address - State:ME
Mailing Address - Zip Code:04086-6186
Mailing Address - Country:US
Mailing Address - Phone:207-725-4400
Mailing Address - Fax:
Practice Address - Street 1:439 LEWISTON RD
Practice Address - Street 2:
Practice Address - City:TOPSHAM
Practice Address - State:ME
Practice Address - Zip Code:04086-6186
Practice Address - Country:US
Practice Address - Phone:207-725-4400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-11-13
Last Update Date:2018-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEPT5261225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist