Provider Demographics
NPI:1497792709
Name:FLORES, MARY ROANNE (MSPT)
Entity Type:Individual
Prefix:MISS
First Name:MARY
Middle Name:ROANNE
Last Name:FLORES
Suffix:
Gender:F
Credentials:MSPT
Other - Prefix:
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Mailing Address - Street 1:348 WARBURTON AVE
Mailing Address - Street 2:
Mailing Address - City:HASTINGS ON HUDSON
Mailing Address - State:NY
Mailing Address - Zip Code:10706-2809
Mailing Address - Country:US
Mailing Address - Phone:914-478-9390
Mailing Address - Fax:
Practice Address - Street 1:313 CENTRAL PARK AVE
Practice Address - Street 2:
Practice Address - City:SCARSDALE
Practice Address - State:NY
Practice Address - Zip Code:10583-1349
Practice Address - Country:US
Practice Address - Phone:914-946-5685
Practice Address - Fax:914-946-0304
Is Sole Proprietor?:No
Enumeration Date:2006-06-02
Last Update Date:2013-10-03
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY026155-1225100000X, 2251P0200X, 2251S0007X, 2251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatrics
No2251S0007XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistSports