Provider Demographics
NPI:1184706871
Name:D IORIO, DEBRA H (DPT)
Entity type:Individual
Prefix:
First Name:DEBRA
Middle Name:H
Last Name:D IORIO
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:DEBRA
Other - Middle Name:H
Other - Last Name:STAUFFACHER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DPT
Mailing Address - Street 1:31 OLD ROUTE 7
Mailing Address - Street 2:
Mailing Address - City:BROOKFIELD
Mailing Address - State:CT
Mailing Address - Zip Code:06804-1714
Mailing Address - Country:US
Mailing Address - Phone:203-740-0020
Mailing Address - Fax:203-775-0238
Practice Address - Street 1:816 BROAD ST
Practice Address - Street 2:
Practice Address - City:MERIDEN
Practice Address - State:CT
Practice Address - Zip Code:06450-4350
Practice Address - Country:US
Practice Address - Phone:203-238-1334
Practice Address - Fax:203-238-1351
Is Sole Proprietor?:No
Enumeration Date:2006-10-20
Last Update Date:2009-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT007946225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT004263852Medicaid
CT080007945CT04OtherANTHEM BC-MERIDEN
CT650001324Medicare PIN