Provider Demographics
NPI:1023348240
Name:ROMARATE, MARYCRIS SELORIO (PT)
Entity type:Individual
Prefix:MS
First Name:MARYCRIS
Middle Name:SELORIO
Last Name:ROMARATE
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 1:8635 QUEENS BLVD STE 1B
Mailing Address - Street 2:
Mailing Address - City:ELMHURST
Mailing Address - State:NY
Mailing Address - Zip Code:11373-4408
Mailing Address - Country:US
Mailing Address - Phone:718-533-1249
Mailing Address - Fax:
Practice Address - Street 1:8635 QUEENS BLVD STE 1B
Practice Address - Street 2:
Practice Address - City:ELMHURST
Practice Address - State:NY
Practice Address - Zip Code:11373-4408
Practice Address - Country:US
Practice Address - Phone:718-533-1249
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-01-11
Last Update Date:2010-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY019943225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist