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General NPI Number Information
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NPI Number | 1518461664
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Entity Type | Individual
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Provider Name | DEBRA DELLACAVA PTA
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Gender | Female
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Dates
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Enumeration Date | 03/22/2018
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Last Update Date | 03/22/2018
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Provider Practice Location Address
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Address Line | 8 HAMPTON RD
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City | EXETER
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State | NH
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Zip | 03833-4806
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Country | US
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Telephone | 603-778-0531
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Fax |
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Provider Business Mailing Address
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Address Line | 17 OVERLEDGE DR
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City | DERRY
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State | NH
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Zip | 03038-5312
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Country | US
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Telephone | 603-505-2487
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Fax |
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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 | 225200000X
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Taxonomy Name | Physical Therapy Assistant
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License Number | 1079
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License Number State | NH
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