MEDICARE: CINDY BERMUDEZ PTA

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	225200000X	Physical Therapy Assistant	160005237	IL
2	225200000X	Physical Therapy Assistant	007081-1	NY
3	225200000X	Physical Therapy Assistant	PTA21932	FL
4	225200000X	Physical Therapy Assistant	P160156334	WA
5	225200000X	Physical Therapy Assistant	9393	CA

General Provider Information

NPI Number	:	1356628176
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CINDY BERMUDEZ PTA

Provider Business Mailing Address
First Line	:	5 BENTLEY DR
Second Line	:
City	:	TROY
State	:	NY
Zip	:	12182-9722
Country	:	US
Telephone Number	:	617-947-5311
Fax Number	:

Provider Business Practice Location Address
First Line	:	5 BENTLEY DR
Second Line	:
City	:	TROY
State	:	NY
Zip	:	12182-9722
Country	:	US
Telephone Number	:	617-947-5311
Fax Number	:

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

Provider Enumeration Date	:	11/08/2011
Last Update Date	:	11/08/2011

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Directions to “ CINDY BERMUDEZ PTA” Practice Location

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