Provider Demographics
NPI:1518277870
Name:TERRUSA, MELISSA (DPT)
Entity type:Individual
Prefix:
First Name:MELISSA
Middle Name:
Last Name:TERRUSA
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:31 NEW DORP LANE
Mailing Address - Street 2:SUITE 1LL
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10306-2320
Mailing Address - Country:US
Mailing Address - Phone:718-370-3500
Mailing Address - Fax:718-979-5236
Practice Address - Street 1:33 RICHMOND HILL ROAD
Practice Address - Street 2:
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10314
Practice Address - Country:US
Practice Address - Phone:718-982-6340
Practice Address - Fax:718-979-5236
Is Sole Proprietor?:No
Enumeration Date:2010-10-20
Last Update Date:2010-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY033066225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist