MEDICARE: VINCENT WILLIAM VERNO PT

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
1	225100000X	Physical Therapist	PT006140L	PA

General Provider Information

NPI Number	:	1154800571
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	VINCENT WILLIAM VERNO PT

Provider Business Mailing Address
First Line	:	12 S 23RD ST
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19103-3014
Country	:	US
Telephone Number	:	215-523-7600
Fax Number	:	215-523-6982

Provider Business Practice Location Address
First Line	:	12 S 23RD ST
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19103-3014
Country	:	US
Telephone Number	:	215-523-7600
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/07/2018
Last Update Date	:	08/07/2018

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Directions to “ VINCENT WILLIAM VERNO PT” Practice Location

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