Healthcare Provider Details

I. General information

NPI: 1801884325
Provider Name (Legal Business Name): CAROL ANN STRAITON P.T.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/10/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

805 FLORAL VALE BLVD
YARDLEY PA
19067-5513
US

IV. Provider business mailing address

805 FLORAL VALE BLVD
YARDLEY PA
19067-5513
US

V. Phone/Fax

Practice location:
  • Phone: 215-968-4901
  • Fax: 215-968-9718
Mailing address:
  • Phone: 215-968-4901
  • Fax: 215-968-9718

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT001360E
License Number StatePA

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

# 1
Identifier1201735
Identifier TypeOTHER
Identifier State
Identifier IssuerFIRST HEALTH
# 2
Identifier288083
Identifier TypeOTHER
Identifier State
Identifier IssuerMAMSI LIFE & HEALTH
# 3
Identifier7855371
Identifier TypeOTHER
Identifier State
Identifier IssuerAETNA - NON HMO
# 4
Identifier3094817
Identifier TypeOTHER
Identifier State
Identifier IssuerAETNA - HMO
# 5
IdentifierST634922
Identifier TypeOTHER
Identifier State
Identifier IssuerHIGHMARK BLUE SHIELD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: