Provider Demographics
NPI:1780836924
Name:NUSSO, DIANE CATHERINE (PHYSICAL THERAPIST)
Entity Type:Individual
Prefix:MS
First Name:DIANE
Middle Name:CATHERINE
Last Name:NUSSO
Suffix:
Gender:F
Credentials:PHYSICAL THERAPIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21 STONE CREEK LN
Mailing Address - Street 2:
Mailing Address - City:BRIARCLIFF MANOR
Mailing Address - State:NY
Mailing Address - Zip Code:10510-1551
Mailing Address - Country:US
Mailing Address - Phone:914-944-0622
Mailing Address - Fax:
Practice Address - Street 1:21 STONE CREEK LN
Practice Address - Street 2:
Practice Address - City:BRIARCLIFF MANOR
Practice Address - State:NY
Practice Address - Zip Code:10510-1551
Practice Address - Country:US
Practice Address - Phone:914-944-0622
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-21
Last Update Date:2008-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY009388-1225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist