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General NPI Number Information
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NPI Number | 1295076198
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Entity Type | Individual
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Provider Name | EMILY T ARDOLINO P.T.
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Gender | Female
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Dates
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Enumeration Date | 03/04/2013
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Last Update Date | 12/30/2019
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Provider Practice Location Address
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Address Line | 8201 ATLEE RD STE D
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City | MECHANICSVILLE
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State | VA
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Zip | 23116-1815
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Country | US
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Telephone | 804-569-1787
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Fax | 804-569-9787
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Provider Business Mailing Address
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Address Line | 8322 BELLONA AVE SUITE 100
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City | TOWSON
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State | MD
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Zip | 21204-2065
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Country | US
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Telephone | 410-337-8847
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Fax | 410-337-5189
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 24399
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License Number State | MD
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Taxonomy #2
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 2305213330
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License Number State | VA
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