Provider Demographics
NPI:1154461713
Name:LERRO, DARIA MICHELLE (MSPT)
Entity Type:Individual
Prefix:MRS
First Name:DARIA
Middle Name:MICHELLE
Last Name:LERRO
Suffix:
Gender:F
Credentials:MSPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1732 AUBURN RD
Mailing Address - Street 2:
Mailing Address - City:WANTAGH
Mailing Address - State:NY
Mailing Address - Zip Code:11793-3513
Mailing Address - Country:US
Mailing Address - Phone:516-781-6797
Mailing Address - Fax:516-781-6797
Practice Address - Street 1:20001 42ND AVE
Practice Address - Street 2:
Practice Address - City:BAYSIDE
Practice Address - State:NY
Practice Address - Zip Code:11361-1872
Practice Address - Country:US
Practice Address - Phone:718-224-0490
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-06
Last Update Date:2008-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0635982251P0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatrics