Provider Demographics
NPI:1427202183
Name:WASKOWITZ PINERO, MARY JEANNE WASKOWITZ (DPT)
Entity Type:Individual
Prefix:DR
First Name:MARY
Middle Name:JEANNE WASKOWITZ
Last Name:WASKOWITZ PINERO
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:DR
Other - First Name:MARY
Other - Middle Name:JEANNE WASKOWITZ
Other - Last Name:CARNEVALE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DPT
Mailing Address - Street 1:501 E HARDY ST
Mailing Address - Street 2:SUITE 410
Mailing Address - City:INGLEWOOD
Mailing Address - State:CA
Mailing Address - Zip Code:90301-4054
Mailing Address - Country:US
Mailing Address - Phone:310-412-0100
Mailing Address - Fax:310-412-0110
Practice Address - Street 1:501 E HARDY ST
Practice Address - Street 2:SUITE 410
Practice Address - City:INGLEWOOD
Practice Address - State:CA
Practice Address - Zip Code:90301-4054
Practice Address - Country:US
Practice Address - Phone:310-412-0100
Practice Address - Fax:310-412-0110
Is Sole Proprietor?:No
Enumeration Date:2008-11-07
Last Update Date:2010-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA264962251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic