MEDICARE: MRS. CARMEN ZORIDA RIVERA P.T.

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	PT001020E	PA

General Provider Information

NPI Number	:	1457497562
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. CARMEN ZORIDA RIVERA P.T.

Provider Business Mailing Address
First Line	:	44 VALENTINE RD
Second Line	:
City	:	WARMINSTER
State	:	PA
Zip	:	18974-6158
Country	:	US
Telephone Number	:	215-443-8765
Fax Number	:	215-427-2433

Provider Business Practice Location Address
First Line	:	3300 ARAMINGO AVE
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19134-4500
Country	:	US
Telephone Number	:	215-427-2242
Fax Number	:	215-427-2433

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

Provider Enumeration Date	:	01/29/2007
Last Update Date	:	12/06/2010

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