Colleen Lynn Bevilacqua, PT
Individual provider Active NPI Physical Therapist · Scotia, NY
NPI 1871898809 · NPPES record last updated Sep 14, 2011
Key facts
- NPI
- 1871898809
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapist 225100000X
- License
- 022129 (NY)
- Practice address
- 11 Bruce St
Scotia, NY 12302-2312 - Phone
- (518) 391-3334
- NPI assigned
- Jan 23, 2011
- 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)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 022129 | NY | MD | Physician Assistant |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 022129 | NY | Yes |
Addresses
Primary practice location
11 Bruce St
Scotia, NY 12302-2312
Mailing address
11 Bruce St
Scotia, NY 12302-2312
Phone (518) 391-3334
Other providers in Scotia, NY
- Joanne Becker
- Erin Belanger
- Frank Brian Bell
- Teresa Ann Benosky
- Viola Berenyi
- Lori Ann Bloomus
- Diane E Bonesteel
- Rachel Christine Bradley
- Alyson Reiter Brener
- Jessica Brennan
All providers in Scotia, 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 Sep 14, 2011. 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.