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NPI Code Detail

MEDICARE: DAVID HARRY LEOMBRUNO PTA

MEDICARE: DAVID HARRY LEOMBRUNO PTA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225200000XPhysical Therapy Assistant9393MA

General Provider Information

NPI Number : 1033764386
Entity Type Code : Individual
Provider Name (Legal Business Name) : DAVID HARRY LEOMBRUNO PTA
Provider Business Mailing Address
First Line : 30 SAINT JACQUES AVE
Second Line :
City : CHICOPEE
State : MA
Zip : 01020-4254
Country : US
Telephone Number : 774-766-2482
Fax Number :
Provider Business Practice Location Address
First Line : 11 SAINT ANTHONY ST
Second Line :
City : CHICOPEE
State : MA
Zip : 01013-2141
Country : US
Telephone Number : 413-315-4205
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/05/2019
Last Update Date : 08/05/2019

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