Provider Demographics
NPI:1053509661
Name:CONSOLO, MARIA ARCE (PT)
Entity Type:Individual
Prefix:MRS
First Name:MARIA
Middle Name:ARCE
Last Name:CONSOLO
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:MARIA LEA
Other - Middle Name:ACLO
Other - Last Name:ARCE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PT
Mailing Address - Street 1:316 N GREELEY AVE
Mailing Address - Street 2:
Mailing Address - City:CHAPPAQUA
Mailing Address - State:NY
Mailing Address - Zip Code:10514-2748
Mailing Address - Country:US
Mailing Address - Phone:917-365-1852
Mailing Address - Fax:
Practice Address - Street 1:316 N GREELEY AVE
Practice Address - Street 2:
Practice Address - City:CHAPPAQUA
Practice Address - State:NY
Practice Address - Zip Code:10514-2748
Practice Address - Country:US
Practice Address - Phone:917-365-1852
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-09
Last Update Date:2020-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY015304225100000X, 174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No174400000XOther Service ProvidersSpecialist