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General NPI Number Information
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NPI Number | 1720637002
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Entity Type | Individual
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Provider Name | PAIGE ARIANA BROCATO DPT
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Gender | Female
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Dates
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Enumeration Date | 09/09/2019
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Last Update Date | 11/01/2021
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Provider Practice Location Address
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Address Line | 305 N UNION ST STE 101
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City | WILMINGTON
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State | DE
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Zip | 19805-3453
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Country | US
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Telephone | 302-778-0810
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Fax | 302-778-0812
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Provider Business Mailing Address
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Address Line | 350 NEW FIDELITY CT
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City | GARNER
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State | NC
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Zip | 27529-2665
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Country | US
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Telephone | 919-258-2714
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Fax | 410-648-4878
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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 | PT027952
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License Number State | PA
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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 | J1-0014433
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License Number State | DE
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