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NPI Code Detail

MEDICARE: CAROLINE TREZONA PT, DPT, ATC

MEDICARE: CAROLINE TREZONA PT, DPT, ATC
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 Therapist
2225100000XPhysical TherapistP19020NC

General Provider Information

NPI Number : 1417502832
Entity Type Code : Individual
Provider Name (Legal Business Name) : CAROLINE TREZONA PT, DPT, ATC
Provider Business Mailing Address
First Line : 1311 MAMARONECK AVE STE 140
Second Line :
City : WHITE PLAINS
State : NY
Zip : 10605-5224
Country : US
Telephone Number : 919-258-2200
Fax Number :
Provider Business Practice Location Address
First Line : 500 VILLAGE WALK DR
Second Line :
City : HOLLY SPRINGS
State : NC
Zip : 27540-4440
Country : US
Telephone Number : 919-258-2200
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/02/2019
Last Update Date : 06/17/2022

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