Provider Demographics
NPI:1336455104
Name:VERNON, DIONNE OKOLO (DPT)
Entity Type:Individual
Prefix:
First Name:DIONNE
Middle Name:OKOLO
Last Name:VERNON
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:147 W 24TH ST
Mailing Address - Street 2:7TH FLOOR
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10011-1911
Mailing Address - Country:US
Mailing Address - Phone:212-997-7490
Mailing Address - Fax:212-997-7492
Practice Address - Street 1:147 W 24TH ST
Practice Address - Street 2:7TH FLOOR
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10011-1911
Practice Address - Country:US
Practice Address - Phone:212-997-7490
Practice Address - Fax:212-997-7492
Is Sole Proprietor?:No
Enumeration Date:2010-08-31
Last Update Date:2017-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist