Provider Demographics
NPI:1518057223
Name:DULFO, MARIZZA (RPT)
Entity Type:Individual
Prefix:MRS
First Name:MARIZZA
Middle Name:
Last Name:DULFO
Suffix:
Gender:F
Credentials:RPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:240 S 3RD ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11211-5602
Mailing Address - Country:US
Mailing Address - Phone:718-302-0456
Mailing Address - Fax:718-218-8878
Practice Address - Street 1:240 S 3RD ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11211-5602
Practice Address - Country:US
Practice Address - Phone:718-302-0456
Practice Address - Fax:718-218-8878
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-13
Last Update Date:2011-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY019561225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYA400017607Medicare PIN