Healthcare Provider Details

I. General information

NPI: 1063332302
Provider Name (Legal Business Name): COLIN CASCIO
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/17/2026
Last Update Date: 07/17/2026
Certification Date: 07/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1510 DEKALB PIKE
BLUE BELL PA
19422-3300
US

IV. Provider business mailing address

1306 MEADOW DR
BLUE BELL PA
19422-3303
US

V. Phone/Fax

Practice location:
  • Phone: 443-987-0753
  • Fax:
Mailing address:
  • Phone: 443-987-0753
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License NumberTE013995
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: