Provider Demographics
NPI:1467537514
Name:PLAZA, DELIA ESTONILO (PHYSICAL THERAPIST)
Entity Type:Individual
Prefix:MS
First Name:DELIA
Middle Name:ESTONILO
Last Name:PLAZA
Suffix:
Gender:F
Credentials:PHYSICAL THERAPIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4 TUCKAHOE RD
Mailing Address - Street 2:
Mailing Address - City:YONKERS
Mailing Address - State:NY
Mailing Address - Zip Code:10710-5319
Mailing Address - Country:US
Mailing Address - Phone:914-476-0951
Mailing Address - Fax:914-476-0948
Practice Address - Street 1:4 TUCKAHOE RD
Practice Address - Street 2:
Practice Address - City:YONKERS
Practice Address - State:NY
Practice Address - Zip Code:10710-5319
Practice Address - Country:US
Practice Address - Phone:914-476-0951
Practice Address - Fax:914-476-0948
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-26
Last Update Date:2017-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1059701225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYQ71411Medicare ID - Type Unspecified