MEDICARE: ROBERT L LACAVA P.T.

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	PT016023	PA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	251570641	OTHER	PA	TAX ID

General Provider Information

NPI Number	:	1184630568
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ROBERT L LACAVA P.T.

Provider Business Mailing Address
First Line	:	812 BROAD AVE
Second Line	:
City	:	BELLE VERNON
State	:	PA
Zip	:	15012-1664
Country	:	US
Telephone Number	:	724-929-5774
Fax Number	:	724-929-9524

Provider Business Practice Location Address
First Line	:	2419 STATE AVE STE 100
Second Line	:
City	:	CORAOPOLIS
State	:	PA
Zip	:	15108-2233
Country	:	US
Telephone Number	:	412-625-2621
Fax Number	:	412-625-2623

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

Provider Enumeration Date	:	07/31/2006
Last Update Date	:	12/06/2024

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