Provider Demographics
NPI:1417129487
Name:PENNACCHIO-FERRI, DEBRA L (PT)
Entity Type:Individual
Prefix:
First Name:DEBRA
Middle Name:L
Last Name:PENNACCHIO-FERRI
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 1:185 MAPLE AVE
Mailing Address - Street 2:SUITE 124
Mailing Address - City:WHITE PLAINS
Mailing Address - State:NY
Mailing Address - Zip Code:10601-4776
Mailing Address - Country:US
Mailing Address - Phone:914-997-6970
Mailing Address - Fax:914-946-4619
Practice Address - Street 1:185 MAPLE AVE
Practice Address - Street 2:SUITE 124
Practice Address - City:WHITE PLAINS
Practice Address - State:NY
Practice Address - Zip Code:10601-4776
Practice Address - Country:US
Practice Address - Phone:914-997-6970
Practice Address - Fax:914-946-4619
Is Sole Proprietor?:Yes
Enumeration Date:2008-03-30
Last Update Date:2008-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY005547-1225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYQ52241OtherEMPIRE BC/BS
NYQ52241Medicare PIN