Cecelia Fedele

Individual provider Active NPI Athletic Trainer · Philadelphia, PA

NPI 1639610975 · NPPES record last updated Mar 20, 2017

Key facts

NPI
1639610975
Entity type
Individual (NPI type 1)
Primary specialty
Athletic Trainer 2255A2300X
License
RT005591 (PA)
Practice address
4201 Henry Ave
Philadelphia, PA 19144-5409
Phone
(215) 951-2726
NPI assigned
Mar 20, 2017
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
RT005591PAMDAthletic Trainer

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Athletic Trainer 2255A2300X RT005591 PA Yes

Addresses

Primary practice location

4201 Henry Ave
Philadelphia, PA 19144-5409

Mailing address

4201 Henry Ave
Philadelphia, PA 19144-5409
Phone (215) 951-2726

Other providers in Philadelphia, PA

All providers in Philadelphia, PA · Athletic Trainer in Pennsylvania

Sources for this page

Verify at the official NPI Registry.