Provider Demographics
NPI:1235443383
Name:YACUZZO, TRACEY L (DPT)
Entity Type:Individual
Prefix:
First Name:TRACEY
Middle Name:L
Last Name:YACUZZO
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:TRACEY
Other - Middle Name:L
Other - Last Name:ABBOTT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DPT
Mailing Address - Street 1:515 WEST WASHINGTON STREET
Mailing Address - Street 2:
Mailing Address - City:GENEVA
Mailing Address - State:NY
Mailing Address - Zip Code:14456
Mailing Address - Country:US
Mailing Address - Phone:315-781-1010
Mailing Address - Fax:315-781-1711
Practice Address - Street 1:515 WEST WASHINGTON STREET
Practice Address - Street 2:
Practice Address - City:GENEVA
Practice Address - State:NY
Practice Address - Zip Code:14456
Practice Address - Country:US
Practice Address - Phone:315-781-1010
Practice Address - Fax:315-781-1722
Is Sole Proprietor?:No
Enumeration Date:2010-07-31
Last Update Date:2013-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY032926225100000X
NY032926-1225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist