Healthcare Provider Details
I. General information
NPI: 1689795767
Provider Name (Legal Business Name): LISA S MADIGAN-CAREY PT
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 04/03/2007
Last Update Date: 04/07/2025
Certification Date: 04/07/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
8965 GUILFORD RD STE 160
COLUMBIA MD
21046-2396
US
IV. Provider business mailing address
2994 OLD AIRPORT RD
NEW BERN NC
28562-8738
US
V. Phone/Fax
- Phone: 410-474-4397
- Fax:
- Phone: 252-672-8680
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 2251P0200X |
| Taxonomy | Pediatric Physical Therapist |
| License Number | P18523 |
| License Number State | NC |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: