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NPI Code Detail

MEDICARE: DIANE J. WOOLDRIDGE PT

MEDICARE: DIANE J. WOOLDRIDGE 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
1225100000XPhysical Therapist009744-1NY
2225100000XPhysical Therapist11156SC

General Provider Information

NPI Number : 1275531675
Entity Type Code : Individual
Provider Name (Legal Business Name) : DIANE J. WOOLDRIDGE PT
Provider Business Mailing Address
First Line : 1311 MAMARONECK AVE STE 140
Second Line :
City : WHITE PLAINS
State : NY
Zip : 10605-5224
Country : US
Telephone Number : 914-294-4050
Fax Number : 315-853-7629
Provider Business Practice Location Address
First Line : 439 CHANNEL RD STE 102
Second Line :
City : LAKE WYLIE
State : SC
Zip : 29710-6101
Country : US
Telephone Number : 803-746-7800
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/08/2005
Last Update Date : 06/27/2022

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Directions to “ DIANE J. WOOLDRIDGE PT” Practice Location

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