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General NPI Number Information
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NPI Number | 1992167464
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Entity Type | Individual
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Provider Name | CONSTANCE CIERRA CARDOZA DPT, PT
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Gender | Female
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Dates
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Enumeration Date | 03/24/2016
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Last Update Date | 12/01/2025
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Provider Practice Location Address
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Address Line | 540 MAIN ST
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City | WORCESTER
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State | MA
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Zip | 01608-2014
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Country | US
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Telephone | 507-438-7490
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Fax |
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Provider Business Mailing Address
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Address Line | 64 S LENOX ST APT 1
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City | WORCESTER
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State | MA
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Zip | 01602-2558
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Country | US
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Telephone | 732-208-5333
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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 | 4081
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License Number State | NH
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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 | PTL24944
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License Number State | MA
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Taxonomy #3
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 40QA01654300
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License Number State | NJ
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