Provider Demographics
NPI:1578848610
Name:NORMAN, MARIA IVONNE (PT, DPT)
Entity Type:Individual
Prefix:
First Name:MARIA IVONNE
Middle Name:
Last Name:NORMAN
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5564 W CENTER RD
Mailing Address - Street 2:
Mailing Address - City:LINESVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:16424-7744
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:5564 W CENTER RD
Practice Address - Street 2:
Practice Address - City:LINESVILLE
Practice Address - State:PA
Practice Address - Zip Code:16424-7744
Practice Address - Country:US
Practice Address - Phone:718-945-6350
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-10-20
Last Update Date:2024-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR4531225100000X
PAPT0216862251G0304X
NY0324932251G0304X
2251P0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatrics
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No2251G0304XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGeriatrics