Provider Demographics
NPI:1952892283
Name:DELGADILLO, DENISSE (PT, DPT)
Entity Type:Individual
Prefix:
First Name:DENISSE
Middle Name:
Last Name:DELGADILLO
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:80 BROAD ST STE 1401
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10004-2249
Mailing Address - Country:US
Mailing Address - Phone:212-943-4999
Mailing Address - Fax:212-943-1999
Practice Address - Street 1:80 BROAD ST STE 1401
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10004-2249
Practice Address - Country:US
Practice Address - Phone:212-943-4999
Practice Address - Fax:212-943-1999
Is Sole Proprietor?:Yes
Enumeration Date:2018-05-22
Last Update Date:2018-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY042945225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist