Provider Demographics
NPI:1730466756
Name:MACURA, EMILY J (DPT)
Entity Type:Individual
Prefix:
First Name:EMILY
Middle Name:J
Last Name:MACURA
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:EMILY
Other - Middle Name:J
Other - Last Name:ZEIGLER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DPT
Mailing Address - Street 1:28 4TH ST
Mailing Address - Street 2:
Mailing Address - City:FAIR HAVEN
Mailing Address - State:VT
Mailing Address - Zip Code:05743-1053
Mailing Address - Country:US
Mailing Address - Phone:802-265-4055
Mailing Address - Fax:802-265-8838
Practice Address - Street 1:28 4TH ST
Practice Address - Street 2:
Practice Address - City:FAIR HAVEN
Practice Address - State:VT
Practice Address - Zip Code:05743-1053
Practice Address - Country:US
Practice Address - Phone:802-265-4055
Practice Address - Fax:802-265-8838
Is Sole Proprietor?:No
Enumeration Date:2011-11-04
Last Update Date:2015-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY033979-1225100000X
VT0400080434225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYJ400072504OtherMEDICARE NUMBER