Provider Demographics
NPI:1912097296
Name:DEMITROVIC, KERRI YVONNE (PT)
Entity Type:Individual
Prefix:
First Name:KERRI
Middle Name:YVONNE
Last Name:DEMITROVIC
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 1:62 MOHICAN PK AVE
Mailing Address - Street 2:
Mailing Address - City:DOBBS FERRY
Mailing Address - State:NY
Mailing Address - Zip Code:10522-2309
Mailing Address - Country:US
Mailing Address - Phone:914-844-7580
Mailing Address - Fax:914-478-3106
Practice Address - Street 1:62 MOHICAN PK AVE
Practice Address - Street 2:
Practice Address - City:DOBBS FERRY
Practice Address - State:NY
Practice Address - Zip Code:10522-2309
Practice Address - Country:US
Practice Address - Phone:914-844-7580
Practice Address - Fax:914-478-3106
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-15
Last Update Date:2017-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0242461225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist