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General NPI Number Information
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NPI Number | 1629551288
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Entity Type | Individual
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Provider Name | VIRGINIA SERRUTO PT
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Gender | Female
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Dates
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Enumeration Date | 09/10/2018
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Last Update Date | 07/10/2023
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Provider Practice Location Address
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Address Line | 1328 ORDERMORE AVE UNIT 4
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City | CHARLOTTE
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State | NC
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Zip | 28203-6136
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Country | US
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Telephone | 914-498-2621
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Fax |
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Provider Business Mailing Address
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Address Line | 1235 EAST BLVD STE E #801
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City | CHARLOTTE
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State | NC
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Zip | 28203-5876
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Country | US
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Telephone | 914-498-2621
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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 | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 041694-1
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License Number State | NY
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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 | P19917
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License Number State | NC
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