Provider Demographics
NPI:1548403686
Name:MESSANO, ANN LUCILLE (PT)
Entity type:Individual
Prefix:
First Name:ANN
Middle Name:LUCILLE
Last Name:MESSANO
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 1:12 FOXVIEW CIR
Mailing Address - Street 2:
Mailing Address - City:HOCKESSIN
Mailing Address - State:DE
Mailing Address - Zip Code:19707-2504
Mailing Address - Country:US
Mailing Address - Phone:302-234-0974
Mailing Address - Fax:302-234-1984
Practice Address - Street 1:12 FOXVIEW CIR
Practice Address - Street 2:
Practice Address - City:HOCKESSIN
Practice Address - State:DE
Practice Address - Zip Code:19707-2504
Practice Address - Country:US
Practice Address - Phone:302-234-0974
Practice Address - Fax:302-234-1984
Is Sole Proprietor?:Yes
Enumeration Date:2009-04-17
Last Update Date:2009-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEJ1-000266225100000X
DEJ1-0000266225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist