Provider Demographics
NPI:1659626042
Name:TERO, ULMAR D (PT)
Entity Type:Individual
Prefix:
First Name:ULMAR
Middle Name:D
Last Name:TERO
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:29 W 138TH ST
Mailing Address - Street 2:APY 1C
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10037-1745
Mailing Address - Country:US
Mailing Address - Phone:401-580-8270
Mailing Address - Fax:401-232-0195
Practice Address - Street 1:29 W 138TH ST
Practice Address - Street 2:APY 1C
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10037-1745
Practice Address - Country:US
Practice Address - Phone:401-580-8270
Practice Address - Fax:401-232-0195
Is Sole Proprietor?:No
Enumeration Date:2012-07-21
Last Update Date:2012-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY62 0349642251G0304X
RIPT023052251G0304X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251G0304XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGeriatrics