MEDICARE: MR. TERENCE THOMAS MCDEVITT PT, CSCS

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	019824-1	NY

General Provider Information

NPI Number	:	1386757599
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. TERENCE THOMAS MCDEVITT PT, CSCS

Provider Business Mailing Address
First Line	:	48 OAKRIDGE RD
Second Line	:
City	:	VERONA
State	:	NJ
Zip	:	07044-1116
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	61 BROADWAY
Second Line	:	SUITE 900
City	:	NEW YORK
State	:	NY
Zip	:	10006-2701
Country	:	US
Telephone Number	:	212-248-0077
Fax Number	:	212-747-0939

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

Provider Enumeration Date	:	08/15/2006
Last Update Date	:	07/08/2007

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