Provider Demographics
NPI:1073770517
Name:ACERO, MA GIRLIE (PT)
Entity Type:Individual
Prefix:
First Name:MA GIRLIE
Middle Name:
Last Name:ACERO
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:MA.GIRLIE
Other - Middle Name:
Other - Last Name:OLMEDO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:20 FLORENCE ST
Mailing Address - Street 2:
Mailing Address - City:FLORAL PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11001-1704
Mailing Address - Country:US
Mailing Address - Phone:516-721-7504
Mailing Address - Fax:
Practice Address - Street 1:20 FLORENCE ST
Practice Address - Street 2:
Practice Address - City:FLORAL PARK
Practice Address - State:NY
Practice Address - Zip Code:11001-1704
Practice Address - Country:US
Practice Address - Phone:516-721-7504
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-05-21
Last Update Date:2013-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY014002-12251G0304X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251G0304XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGeriatrics