Healthcare Provider Details

I. General information

NPI: 1285860692
Provider Name (Legal Business Name): VERA A KARGE P.T.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/01/2009
Last Update Date: 06/01/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8355 LORETTO AVE SUITE 102
PHILADELPHIA PA
19152-1830
US

IV. Provider business mailing address

8355 LORETTO AVE SUITE 102
PHILADELPHIA PA
19152-1830
US

V. Phone/Fax

Practice location:
  • Phone: 215-742-7033
  • Fax: 215-742-7034
Mailing address:
  • Phone: 215-742-7033
  • Fax: 215-742-7034

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT019839
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: