Provider Demographics
NPI:1477645398
Name:IUVARA, CHARO L (PT)
Entity Type:Individual
Prefix:MRS
First Name:CHARO
Middle Name:L
Last Name:IUVARA
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 1:462 ANDREWS ROAD
Mailing Address - Street 2:
Mailing Address - City:MINEOLA
Mailing Address - State:NY
Mailing Address - Zip Code:11501
Mailing Address - Country:US
Mailing Address - Phone:516-294-1262
Mailing Address - Fax:516-741-8051
Practice Address - Street 1:NASSAU REHABILITATION AND SPORTS THEREAPY
Practice Address - Street 2:1337 WILLIS AVENUE
Practice Address - City:MINEOLA
Practice Address - State:NY
Practice Address - Zip Code:11500
Practice Address - Country:US
Practice Address - Phone:516-741-9600
Practice Address - Fax:516-741-8051
Is Sole Proprietor?:No
Enumeration Date:2006-09-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0101151225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
QK6811Medicare ID - Type Unspecified