Healthcare Provider Details

I. General information

NPI: 1457497562
Provider Name (Legal Business Name): CARMEN ZORIDA RIVERA P.T.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/29/2007
Last Update Date: 12/06/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3300 ARAMINGO AVE
PHILADELPHIA PA
19134-4500
US

IV. Provider business mailing address

44 VALENTINE RD
WARMINSTER PA
18974-6158
US

V. Phone/Fax

Practice location:
  • Phone: 215-427-2242
  • Fax: 215-427-2433
Mailing address:
  • Phone: 215-443-8765
  • Fax: 215-427-2433

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT001020E
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: