Provider Demographics
NPI:1407144520
Name:DENIO, ANDREA LEIGH (PT)
Entity Type:Individual
Prefix:MRS
First Name:ANDREA
Middle Name:LEIGH
Last Name:DENIO
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:632 WESTERN AVE
Mailing Address - Street 2:
Mailing Address - City:ALBANY
Mailing Address - State:NY
Mailing Address - Zip Code:12203-1830
Mailing Address - Country:US
Mailing Address - Phone:518-378-5025
Mailing Address - Fax:518-689-0889
Practice Address - Street 1:11831 RT 9W
Practice Address - Street 2:
Practice Address - City:W COXSACKIE
Practice Address - State:NY
Practice Address - Zip Code:12192-3605
Practice Address - Country:US
Practice Address - Phone:518-731-1158
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-07-11
Last Update Date:2023-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY033744-1225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist