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NPI Code Detail

MEDICARE: CHELSEA PEDIGO

MEDICARE: CHELSEA PEDIGO
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
1225100000XPhysical Therapist9588SC
2225100000XPhysical TherapistP18698NC

General Provider Information

NPI Number : 1205389137
Entity Type Code : Individual
Provider Name (Legal Business Name) : CHELSEA PEDIGO
Provider Business Mailing Address
First Line : 1311 MAMARONECK AVE STE 140
Second Line :
City : WHITE PLAINS
State : NY
Zip : 10605-5224
Country : US
Telephone Number : 631-580-5200
Fax Number : 631-580-5222
Provider Business Practice Location Address
First Line : 9216 ARDREY KELL RD STE 300
Second Line :
City : CHARLOTTE
State : NC
Zip : 28277-4954
Country : US
Telephone Number : 980-556-7330
Fax Number : 980-939-8215
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/27/2016
Last Update Date : 05/24/2023

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Directions to “ CHELSEA PEDIGO ” Practice Location

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