Healthcare Provider Details

I. General information

NPI: 1265799142
Provider Name (Legal Business Name): CAROLYN MARIE JOHNSTON-TOME PT, DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/18/2012
Last Update Date: 07/21/2026
Certification Date: 07/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3830 PAULDING AVE
BRONX NY
10469-1299
US

IV. Provider business mailing address

2 HOYE DR
CORTLANDT MANOR NY
10567-6224
US

V. Phone/Fax

Practice location:
  • Phone: 718-882-1212
  • Fax:
Mailing address:
  • Phone: 917-705-3380
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number0315351
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: