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Individual
DAWN MARIE D'AVERSA
Active
Individual
DAWN MARIE D'AVERSA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, PT
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
26819
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00355344
—
NY
01
—
11450962
CAQH
NY
Enumeration date
07/05/2006
Last updated
04/10/2019
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