MEDICARE: COLIN FAGAN

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	TPT024076	PA

General Provider Information

NPI Number	:	1568396141
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	COLIN FAGAN

Provider Business Mailing Address
First Line	:	163 POTTSTOWN PIKE
Second Line	:
City	:	CHESTER SPRINGS
State	:	PA
Zip	:	19425-9518
Country	:	US
Telephone Number	:	610-424-1100
Fax Number	:

Provider Business Practice Location Address
First Line	:	1299 W BALTIMORE PIKE
Second Line	:
City	:	MEDIA
State	:	PA
Zip	:	19063-5759
Country	:	US
Telephone Number	:	610-424-1100
Fax Number	:

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

Provider Enumeration Date	:	06/10/2026
Last Update Date	:	06/10/2026

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Directions to “ COLIN FAGAN ” Practice Location

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