Provider Demographics
NPI:1407331044
Name:IODICE-DADIN, TERESA (MA, PT, CCTT)
Entity Type:Individual
Prefix:MS
First Name:TERESA
Middle Name:
Last Name:IODICE-DADIN
Suffix:
Gender:F
Credentials:MA, PT, CCTT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:333 E 38TH ST
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10016-2772
Mailing Address - Country:US
Mailing Address - Phone:646-501-7077
Mailing Address - Fax:
Practice Address - Street 1:333 1ST AVE
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10003-2914
Practice Address - Country:US
Practice Address - Phone:646-501-7077
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-09-29
Last Update Date:2020-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0087532251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedicGroup - Single Specialty