Healthcare Provider Details

I. General information

NPI: 1164070678
Provider Name (Legal Business Name): CHLOE M CASERO PT, DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/28/2019
Last Update Date: 08/28/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

265 N MAIN ST
SOUTH YARMOUTH MA
02664-2083
US

IV. Provider business mailing address

4611 LEWISTON RD
NIAGARA FALLS NY
14305-1142
US

V. Phone/Fax

Practice location:
  • Phone: 508-394-3514
  • Fax:
Mailing address:
  • Phone: 716-946-1982
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number044593-01
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: