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Physician Compare National (NPI:1992167464)

HEALTHCARE PROVIDER: CONSTANCE CIERRA CARDOZA DPT, PT

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information

NPI 1992167464
Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID 1759650161
Unique individual clinician ID assigned by PECOS
Professional Enrollment ID I20200901002872
Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name FRIERSON
Individual professional last name
Provider First Name CONSTANCE
Individual professional first name
Provider Gender F
The provider's gender if the provider is a person.

Medical School Information

Medical School Name OTHER
Individual professional's medical school
Graduation Year 2014
Individual professional's medical school graduation year
Primary Specialty PHYSICAL THERAPY
Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information

Organization Legal Name PROEX PHYSICAL THERAPY LLC
Legal name of the Group Practice that the individual professional works with- will be blank if the address is not linked to a Group Practice
Group Practice PAC ID 0345212395
Unique Group Practice ID assigned by PECOS to the Group Practice that the individual professional works with- will be blank if the address is not linked to a Group Practice
Number of Group Practice members 104
Total number of individual professionals affiliated with the Group Practice based on Group Practice PAC ID
Line 1 Street Address 165 MAIN ST
Group Practice or individual's line 1 address
Line 2 Street Address UNIT 209
Group Practice or individual's line 2 address
City MEDWAY
Group Practice or individual's city
State MA
Group Practice or individual's state
Zip Code 020531584
Group Practice or individual's zip code (9 digits when available)
Phone Number 5085335778
Phone number is listed only when there is a single phone number available for the practice location address

Hospital(s) Affiliation Information

Professional Accepts Medicare Assignment Y

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