MEDICARE: ZACHARY ROY

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist	PT026976	PA
2	225100000X	Physical Therapist	40QA01797500	NJ
3	2251X0800X	Orthopedic Physical Therapist
4	225100000X	Physical Therapist	29366	MD

General Provider Information

NPI Number	:	1114413879
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ZACHARY ROY

Provider Business Mailing Address
First Line	:	120 W GERMANTOWN PIKE STE 100
Second Line	:
City	:	PLYMOUTH MEETING
State	:	PA
Zip	:	19462-1420
Country	:	US
Telephone Number	:	610-270-0370
Fax Number	:	610-270-0374

Provider Business Practice Location Address
First Line	:	8028 RITCHIE HWY STE 120
Second Line	:
City	:	PASADENA
State	:	MD
Zip	:	21122-1069
Country	:	US
Telephone Number	:	410-590-8750
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/06/2018
Last Update Date	:	02/28/2024

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Directions to “ ZACHARY ROY ” Practice Location

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