Derosa Physical Therapy PC

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

767 Issued in AZ

Legal business name

DEROSA PHYSICAL THERAPY PC

Practice address

1485 N. Turquoise Dr
Suite 220
Flagstaff, AZ 86001

Phone

(928) 774-6626

Fax

(928) 214-3277

NPI assigned

Oct 24, 2006

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Ms. Marlene Marie Derosa, PT

Title

Owner

Phone

(928) 774-6626

Specialties & licenses 1

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1161648000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1302566400000",
    "number": "1164506416",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1485 N. TURQUOISE DR",
            "address_2": "SUITE 220",
            "city": "FLAGSTAFF",
            "state": "AZ",
            "postal_code": "86001",
            "telephone_number": "928-774-6626",
            "fax_number": "928-214-3277"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1485 N. TURQUOISE DR",
            "address_2": "SUITE 220",
            "city": "FLAGSTAFF",
            "state": "AZ",
            "postal_code": "86001",
            "telephone_number": "928-774-6626",
            "fax_number": "928-214-3277"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DEROSA PHYSICAL THERAPY PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-24",
        "last_updated": "2011-04-12",
        "status": "A",
        "authorized_official_last_name": "DEROSA",
        "authorized_official_first_name": "MARLENE",
        "authorized_official_middle_name": "MARIE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "928-774-6626",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": "AZ",
            "license": "767",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Maria Margaret Denny, PMHNP
• Denova Collaborative Health, LLC
• Dentists of Flagstaff, LLP (Dentists of Flagstaff)
• Lakyn Laurel Denton
• Paige Alexandra Deremer-Young, DO, MPH
• Amanda R Derosa, DPT
• Carl Peter Derosa, PT
• Anthony Desjardins, MS, CCP
• Paul Despres, NMD
• George Destefano, RN

• Physical Therapist in Flagstaff, AZ
• Providers in Flagstaff, AZ by specialty
• Physical Therapist in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 12, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.