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General NPI Number Information
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NPI Number | 1578471934
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Entity Type | Individual
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Provider Name | WILFREDO A GERONIMO PT
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Gender | Male
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Dates
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Enumeration Date | 08/28/2026
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Last Update Date | 08/28/2026
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Provider Practice Location Address
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Address Line | 2026 E 54TH ST
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City | INDIANAPOLIS
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State | IN
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Zip | 46220-3490
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Country | US
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Telephone | 317-253-6050
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Fax | 317-257-2474
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Provider Business Mailing Address
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Address Line | 11229 ARBORWOOD TRL
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City | CARMEL
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State | IN
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Zip | 46032-6923
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Country | US
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Telephone | 317-201-2187
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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 | 2251G0304X
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Taxonomy Name | Geriatric Physical Therapist
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License Number | 05003037A
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License Number State | IN
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