MEDICARE: KATHARINE CARACCIOLO DPT

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	20902	MA

General Provider Information

NPI Number	:	1396176053
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KATHARINE CARACCIOLO DPT

Provider Business Mailing Address
First Line	:	169 NORTH FRANKLIN ST
Second Line	:	GROUND FLOOR
City	:	HOLBROOK
State	:	MA
Zip	:	02343-1174
Country	:	US
Telephone Number	:	781-767-5200
Fax Number	:	781-767-5202

Provider Business Practice Location Address
First Line	:	169 NORTH FRANKLIN ST
Second Line	:	GROUND FLOOR
City	:	HOLBROOK
State	:	MA
Zip	:	02343-1174
Country	:	US
Telephone Number	:	781-767-5200
Fax Number	:	781-767-5202

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

Provider Enumeration Date	:	12/06/2013
Last Update Date	:	01/16/2024

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Directions to “ KATHARINE CARACCIOLO DPT” Practice Location

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