Provider Demographics
NPI:1417185018
Name:DEQUATRO, VITA M (DOCTORATE OF PT)
Entity Type:Individual
Prefix:DR
First Name:VITA
Middle Name:M
Last Name:DEQUATRO
Suffix:
Gender:F
Credentials:DOCTORATE OF PT
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Other - Last Name:
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Mailing Address - Street 1:115 MAIN ST
Mailing Address - Street 2:SUITE#202 2ND FLOOR
Mailing Address - City:TUCKAHOE
Mailing Address - State:NY
Mailing Address - Zip Code:10707-2948
Mailing Address - Country:US
Mailing Address - Phone:914-961-1010
Mailing Address - Fax:914-961-1011
Practice Address - Street 1:115 MAIN ST
Practice Address - Street 2:SUITE#202 2ND FLOOR
Practice Address - City:TUCKAHOE
Practice Address - State:NY
Practice Address - Zip Code:10707-2948
Practice Address - Country:US
Practice Address - Phone:914-961-1010
Practice Address - Fax:914-961-1011
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-23
Last Update Date:2015-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0383371225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PENDINGOtherAETNA ORHTONET-MCLEAN AVENUE
PENDINGOtherAETNA LOCAL 1199
PENDINGOtherAMERIGROUP
PENDINGOtherCIGNA ORHTONET MCLEAN
PENDINGOtherGEHA
PENDINGOtherUS FAMILY HEALTH-ORTHONET TUCKAHOE
PENDINGOtherUS FAMILLY HEALTH-ORTHONET MCLEAN
PENDINGOtherAMIDACARE
PENDINGOtherFIDELIS HEALHCARE
PENDINGOtherPOMCO
PENDINGOtherAFFINITY HEALTH PLAN
PENDINGOtherEMBLEM HEALTH
PENDINGOtherEMPIRE BLUE CROSS
PENDINGOtherFPN
PENDINGOtherHUMANA
PENDINGOtherMULTIPLAN
PENDINGOtherOPTUM PHYSICAL THERAPY/EMPIRE/OXFORD/UHC
PENDINGOtherMAGNACARE
PENDINGOtherVNS-NYS
NYPENDINGMedicaid
PENDINGOtherAETNA ORTHONET-TUCKAHOE
PENDINGOtherMVP HEALTHCARE
PENDINGOtherCIGNA ORTHONET TUCKAHOE
PENDINGOtherHEALTHFIRST
PENDINGOtherHUDSON HEALTH
PENDINGOtherHUMANA