Carly Graham
Individual provider Active NPI Physical Therapist · Marietta, NY
NPI 1356706287 · NPPES record last updated Feb 4, 2022
Key facts
- NPI
- 1356706287
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapist 225100000X
- License
- 40QA01649600 (NJ)
- Practice address
- 212 Amber Beach Road
Marietta, NY 13310 - Phone
- (315) 729-9056
- NPI assigned
- Dec 18, 2015
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| On Track Physical Therapy PLLC | Physical Therapist | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 40QA01649600 | NJ | Yes |
Addresses
Primary practice location
212 Amber Beach Road
Marietta, NY 13310
Mailing address
212 Amber Beach Road
Marietta, NY 13310
Phone (315) 729-9056
Other providers in Marietta, NY
- Michael P Bome
- Scott Bronstad
- Gabrielle Conant
- Donna Marie Difulvio
- Ronda Frank
- Hahn Health Care Family NP in Family Health P.C.
- Jessica Ashley Ianuzi
- Cynthia K Warner
- Ann K Yuhas
- Melissa Zacholl
All providers in Marietta, NY · Physical Therapist in New York
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 4, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.