MEDICARE: DAVID DELLOTA DPT, 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	30617	MD

General Provider Information

NPI Number	:	1306688460
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DAVID DELLOTA DPT, PT

Provider Business Mailing Address
First Line	:	1220A E JOPPA RD STE 234
Second Line	:
City	:	TOWSON
State	:	MD
Zip	:	21286-5817
Country	:	US
Telephone Number	:	410-480-3705
Fax Number	:	410-480-3707

Provider Business Practice Location Address
First Line	:	9171 BALTIMORE NATIONAL PIKE STE 120
Second Line	:
City	:	ELLICOTT CITY
State	:	MD
Zip	:	21042-3946
Country	:	US
Telephone Number	:	410-480-3705
Fax Number	:	410-480-3707

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

Provider Enumeration Date	:	06/10/2024
Last Update Date	:	10/30/2025

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