MEDICARE: ELAINE CHICORIA 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	PTA00134	RI

General Provider Information

NPI Number	:	1538349238
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ELAINE CHICORIA PTA

Provider Business Mailing Address
First Line	:	25 BEACH ST
Second Line	:
City	:	WESTERLY
State	:	RI
Zip	:	02891-2762
Country	:	US
Telephone Number	:	401-595-3742
Fax Number	:

Provider Business Practice Location Address
First Line	:	25 BEACH ST
Second Line	:
City	:	WESTERLY
State	:	RI
Zip	:	02891-2762
Country	:	US
Telephone Number	:	401-595-3742
Fax Number	:

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

Provider Enumeration Date	:	11/09/2007
Last Update Date	:	11/09/2007

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Directions to “ ELAINE CHICORIA PTA” Practice Location

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