Provider Demographics
NPI:1225168263
Name:PASSARO, ELISA MARIE (PT)
Entity Type:Individual
Prefix:MS
First Name:ELISA
Middle Name:MARIE
Last Name:PASSARO
Suffix:
Gender:F
Credentials:PT
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Mailing Address - Street 1:3935 E ROUGHRIDER ROAD
Mailing Address - Street 2:#1055
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85050-7350
Mailing Address - Country:US
Mailing Address - Phone:602-463-7797
Mailing Address - Fax:
Practice Address - Street 1:33747 N SCOTTSDALE RD
Practice Address - Street 2:STE 101
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85266-1565
Practice Address - Country:US
Practice Address - Phone:480-687-7535
Practice Address - Fax:480-687-9141
Is Sole Proprietor?:No
Enumeration Date:2007-03-07
Last Update Date:2023-07-20
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
AZ4190225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist