Diana Mary Innocent, PT, DPT | |
80 Route 6 Unit 701702, Baldwin Place, NY 10505-1026 | |
(845) 875-0500 | |
Not Available |
Full Name | Diana Mary Innocent |
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Gender | Female |
Speciality | Physical Therapist |
Location | 80 Route 6 Unit 701702, Baldwin Place, New York |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1295592202 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
225100000X | Physical Therapist | 051531 (New York) | Primary |
Provider Name | Ivyrehab Physical Therapy Pllc |
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Provider Type | Part B Supplier - Clinic/group Practice |
Provider Identifiers | NPI Number: 1396799409 PECOS PAC ID: 7012997638 Enrollment ID: O20040723000705 |
Mailing Address | Practice Location Address |
---|---|
Diana Mary Innocent, PT, DPT 12 Heritage Dr Apt B, New City, NY 10956-5348 Ph: (845) 596-8302 | Diana Mary Innocent, PT, DPT 80 Route 6 Unit 701702, Baldwin Place, NY 10505-1026 Ph: (845) 875-0500 |
Gianna J Volpe, DPT Physical Therapist Medicare: Medicare Enrolled Practice Location: 80 Route 6 Unit 701702, Baldwin Place, NY 10505 Phone: 845-875-0500 | |
Carissa Varbaro Majdanski, MS, PT Physical Therapist Medicare: Medicare Enrolled Practice Location: 80 Route 6 Unit 701702, Baldwin Place, NY 10505 Phone: 845-875-0500 Fax: 845-228-8591 | |
Catherine Marie Cain, DPT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 80 Route 6 Unit 701702, Baldwin Place, NY 10505 Phone: 845-875-0500 |