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NPI Code Detail

MEDICARE: KRISTINA ANN ELIA PT

MEDICARE: KRISTINA ANN ELIA 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 Therapist012360-1NY

General Provider Information

NPI Number : 1316386584
Entity Type Code : Individual
Provider Name (Legal Business Name) : KRISTINA ANN ELIA PT
Provider Business Mailing Address
First Line : 40 SELBORNE CHASE
Second Line :
City : FAIRPORT
State : NY
Zip : 14450-3225
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 500 HAHNEMANN TRL
Second Line :
City : PITTSFORD
State : NY
Zip : 14534-2356
Country : US
Telephone Number : 585-383-1700
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/20/2013
Last Update Date : 02/25/2014

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