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NPI Code Detail

MEDICARE: MRS. COLLEEN THERESA MCGINLEY DPT

MEDICARE: MRS. COLLEEN THERESA MCGINLEY DPT
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 TherapistPT015126PA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
12122587000OTHERPAPERSONAL CHOICE
22719098000OTHERPABLUE CROSS
30007484435OTHERPAAETNA
41860368OTHERPABLUE SHIELD

General Provider Information

NPI Number : 1376647461
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. COLLEEN THERESA MCGINLEY DPT
Provider Business Mailing Address
First Line : 3600 GRANT AVE
Second Line :
City : PHILADELPHIA
State : PA
Zip : 19114-2630
Country : US
Telephone Number : 215-677-0400
Fax Number : 215-677-5181
Provider Business Practice Location Address
First Line : 3600 GRANT AVE
Second Line :
City : PHILADELPHIA
State : PA
Zip : 19114-2630
Country : US
Telephone Number : 215-677-0400
Fax Number : 215-671-1837
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/11/2006
Last Update Date : 02/24/2014

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