Provider Demographics
NPI:1871956433
Name:DIONISIO, DOLORA
Entity type:Individual
Prefix:
First Name:DOLORA
Middle Name:
Last Name:DIONISIO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16 JOSHUA CT
Mailing Address - Street 2:
Mailing Address - City:HOWELL
Mailing Address - State:NJ
Mailing Address - Zip Code:07731-8828
Mailing Address - Country:US
Mailing Address - Phone:732-456-1371
Mailing Address - Fax:
Practice Address - Street 1:16 JOSHUA CT
Practice Address - Street 2:
Practice Address - City:HOWELL
Practice Address - State:NJ
Practice Address - Zip Code:07731-8828
Practice Address - Country:US
Practice Address - Phone:732-456-1371
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-03-31
Last Update Date:2016-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY038840225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist