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NPI Code Detail

MEDICARE: GLENDA GABRIELA VASQUEZ DPT, PT

MEDICARE: GLENDA GABRIELA VASQUEZ DPT, PT
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 TherapistPT03120RI

General Provider Information

NPI Number : 1285117069
Entity Type Code : Individual
Provider Name (Legal Business Name) : GLENDA GABRIELA VASQUEZ DPT, PT
Provider Business Mailing Address
First Line : 109 FAIRVIEW ST
Second Line :
City : PROVIDENCE
State : RI
Zip : 02908-3924
Country : US
Telephone Number : 401-451-1792
Fax Number :
Provider Business Practice Location Address
First Line : 10 RHODES AVE
Second Line :
City : NORTH SMITHFIELD
State : RI
Zip : 02896-6987
Country : US
Telephone Number : 401-767-3500
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/08/2018
Last Update Date : 09/08/2018

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