Provider Demographics
NPI:1730491077
Name:MACRI, SALLYANN (PT)
Entity Type:Individual
Prefix:MRS
First Name:SALLYANN
Middle Name:
Last Name:MACRI
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 1:1024 SHELDON AVENUE
Mailing Address - Street 2:
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10309-2115
Mailing Address - Country:US
Mailing Address - Phone:718-227-7254
Mailing Address - Fax:718-227-7254
Practice Address - Street 1:1024 SHELDON AVENUE
Practice Address - Street 2:
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10309-2115
Practice Address - Country:US
Practice Address - Phone:718-227-7254
Practice Address - Fax:718-227-7254
Is Sole Proprietor?:Yes
Enumeration Date:2010-07-01
Last Update Date:2014-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY017773-1225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist