Provider Demographics
NPI:1659885747
Name:DINISIO, ERIN (PT)
Entity Type:Individual
Prefix:
First Name:ERIN
Middle Name:
Last Name:DINISIO
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 1:1361 FAIRVIEW BLVD STE J
Mailing Address - Street 2:
Mailing Address - City:DELRAN
Mailing Address - State:NJ
Mailing Address - Zip Code:08075-1473
Mailing Address - Country:US
Mailing Address - Phone:856-764-0494
Mailing Address - Fax:856-764-0580
Practice Address - Street 1:1361 FAIRVIEW BLVD STE J
Practice Address - Street 2:
Practice Address - City:DELRAN
Practice Address - State:NJ
Practice Address - Zip Code:08075-1473
Practice Address - Country:US
Practice Address - Phone:856-764-0494
Practice Address - Fax:856-764-0580
Is Sole Proprietor?:Yes
Enumeration Date:2017-11-28
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT016024225100000X
NJ40QA01045200225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist