Provider Demographics
NPI:1558858688
Name:FERARO, MARITONI ALVARADO (PT)
Entity Type:Individual
Prefix:
First Name:MARITONI
Middle Name:ALVARADO
Last Name:FERARO
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 1:38141 OVERBROOK LN
Mailing Address - Street 2:
Mailing Address - City:WESTLAND
Mailing Address - State:MI
Mailing Address - Zip Code:48185-5689
Mailing Address - Country:US
Mailing Address - Phone:734-673-7384
Mailing Address - Fax:734-354-9114
Practice Address - Street 1:38141 OVERBROOK LN
Practice Address - Street 2:
Practice Address - City:WESTLAND
Practice Address - State:MI
Practice Address - Zip Code:48185-5689
Practice Address - Country:US
Practice Address - Phone:734-673-7384
Practice Address - Fax:734-354-9114
Is Sole Proprietor?:Yes
Enumeration Date:2018-04-14
Last Update Date:2018-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5501004268225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist