Christine M Carcanague, PT

Individual provider Active NPI Physical Therapist · Wayne, PA

NPI 1740767698 · NPPES record last updated Jul 24, 2018

Key facts

NPI
1740767698
Entity type
Individual (NPI type 1)
Primary specialty
Physical Therapist 225100000X
License
PT015411 (GA)
Practice address
378 Grange Rd
Wayne, PA 19087-2918
Phone
(610) 225-2451
Fax
(610) 964-6166
NPI assigned
Jul 24, 2018
Sex
Female
Sole proprietor
No

Medicare participation

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

National Provider Directory

Medicare enrollment (NPD)
Yes

State licenses

LicenseStateTypeSpecialty
PT015411GAMDClinical Electrophysiology Physical Therapist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT015411 GA Yes

Addresses

Primary practice location

378 Grange Rd
Wayne, PA 19087-2918

Mailing address

378 Grange Rd
Wayne, PA 19087-2918
Phone (610) 225-2451

Other identifiers

IdentifierTypeStateIssuer
PT015411OtherPALICENSE

Other providers in Wayne, PA

All providers in Wayne, PA · Physical Therapist in Pennsylvania

Sources for this page

Verify at the official NPI Registry.