MEDICARE: VILLAGE PHYSICAL THERAPY AND PILATES AND WELLNESS

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

General Provider Information

NPI Number	:	1518615442
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	VILLAGE PHYSICAL THERAPY AND PILATES AND WELLNESS

Provider Business Mailing Address
First Line	:	213 N MAIN ST
Second Line	:
City	:	NORTH WALES
State	:	PA
Zip	:	19454-3116
Country	:	US
Telephone Number	:	484-535-2880
Fax Number	:

Provider Business Practice Location Address
First Line	:	213 N MAIN ST
Second Line	:
City	:	NORTH WALES
State	:	PA
Zip	:	19454-3116
Country	:	US
Telephone Number	:	484-535-2880
Fax Number	:

Authorized Official
Title or Position	:	PHYSICAL THERAPIST
Name	:	GABRIELLE ABATE
Credential	:
Telephone Number	:	610-772-7664

Provider Enumeration Date	:	03/10/2022
Last Update Date	:	03/10/2022

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Directions to “VILLAGE PHYSICAL THERAPY AND PILATES AND WELLNESS ” Practice Location

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