Healthcare Provider Details

I. General information

NPI: 1275689754
Provider Name (Legal Business Name): CAROL A HUEGEL PT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/26/2007
Last Update Date: 08/09/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1528 WALNUT ST STE 403
PHILADELPHIA PA
19102-3626
US

IV. Provider business mailing address

220 W RITTENHOUSE SQ APT 7E
PHILADELPHIA PA
19103-6841
US

V. Phone/Fax

Practice location:
  • Phone: 215-545-6500
  • Fax:
Mailing address:
  • Phone: 352-871-7749
  • Fax: 352-331-3966

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT022715
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT2449
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: