Provider Demographics
NPI:1245465202
Name:DISALVO, GUY ANTHONY (PT)
Entity type:Individual
Prefix:
First Name:GUY
Middle Name:ANTHONY
Last Name:DISALVO
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 1:1075 CENTRAL PARK AVE
Mailing Address - Street 2:SUITE 301
Mailing Address - City:SCARSDALE
Mailing Address - State:NY
Mailing Address - Zip Code:10583-3242
Mailing Address - Country:US
Mailing Address - Phone:914-723-4900
Mailing Address - Fax:314-723-1893
Practice Address - Street 1:115 MAIN ST
Practice Address - Street 2:
Practice Address - City:TUCKAHOE
Practice Address - State:NY
Practice Address - Zip Code:10707-2948
Practice Address - Country:US
Practice Address - Phone:914-965-1453
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-05-20
Last Update Date:2024-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY029903-1225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist