MEDICARE: DR. KERSTIN M PALOMBARO MS, 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	PT009956L	PA
2	2251G0304X	Geriatric Physical Therapist	PT009956L	PA

General Provider Information

NPI Number	:	1275805442
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. KERSTIN M PALOMBARO MS, PT

Provider Business Mailing Address
First Line	:	1 UNIVERSITY PL
Second Line	:	COTTEE HALL 122
City	:	CHESTER
State	:	PA
Zip	:	19013-5700
Country	:	US
Telephone Number	:	610-499-4270
Fax Number	:	610-499-1231

Provider Business Practice Location Address
First Line	:	2129 PROVIDENCE AVE
Second Line	:
City	:	CHESTER
State	:	PA
Zip	:	19013-5506
Country	:	US
Telephone Number	:	610-499-4585
Fax Number	:

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

Provider Enumeration Date	:	02/03/2012
Last Update Date	:	02/03/2012

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