Provider Demographics
NPI:1326296484
Name:DE LUNA, MARIA CARMELA (DPT, ATC)
Entity Type:Individual
Prefix:
First Name:MARIA
Middle Name:CARMELA
Last Name:DE LUNA
Suffix:
Gender:F
Credentials:DPT, ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:301 N BEAUREGARD ST APT 607
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:VA
Mailing Address - Zip Code:22312-2910
Mailing Address - Country:US
Mailing Address - Phone:732-207-1242
Mailing Address - Fax:
Practice Address - Street 1:301 N BEAUREGARD ST APT 607
Practice Address - Street 2:
Practice Address - City:ALEXANDRIA
Practice Address - State:VA
Practice Address - Zip Code:22312-2910
Practice Address - Country:US
Practice Address - Phone:732-207-1242
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-09-03
Last Update Date:2014-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2305207196225100000X
MD24232225100000X
NJ25MT001408002255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer