Lise Petricone, PT
Physical Therapist, Pediatrics in Nyack, NY. Individual provider (NPI-1).
NPI number1760635668
StatusActive
Last updated in NPPESJul 18, 2011
Details
- NPI
- 1760635668
- Entity type
- Individual (NPI-1)
- Name
- Lise Petricone
- Credential
- PT
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Oct 23, 2008
- Last updated
- Jul 18, 2011
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 2251P0200X | Physical Therapist, Pediatrics | 009027-1 | NY | Yes |
Practice location
21 Burd StNyack, NY 10960-3205
Phone 845-353-2350 · Fax 845-353-2397
Mailing address
21 Burd StNyack, NY 10960-3205
Phone 845-353-2350 · Fax 845-353-2397
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