Provider Demographics
NPI:1952618639
Name:DELIZO-MAMARIL, ROCHELLE DIONE (PHYSICAL THERAPIST)
Entity type:Individual
Prefix:MRS
First Name:ROCHELLE
Middle Name:DIONE
Last Name:DELIZO-MAMARIL
Suffix:
Gender:F
Credentials:PHYSICAL THERAPIST
Other - Prefix:MISS
Other - First Name:ROCHELLEE
Other - Middle Name:PAQUIA
Other - Last Name:DELIZO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:BSPT
Mailing Address - Street 1:150 BEDFORD RD APT F1
Mailing Address - Street 2:
Mailing Address - City:CHAPPAQUA
Mailing Address - State:NY
Mailing Address - Zip Code:10514-2746
Mailing Address - Country:US
Mailing Address - Phone:914-908-0948
Mailing Address - Fax:
Practice Address - Street 1:150 BEDFORD RD APT F1
Practice Address - Street 2:
Practice Address - City:CHAPPAQUA
Practice Address - State:NY
Practice Address - Zip Code:10514-2746
Practice Address - Country:US
Practice Address - Phone:914-908-0948
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-09-02
Last Update Date:2024-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT 20933225100000X
NY015979-1225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist