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NPI Code Detail

MEDICARE: SALLY DRUDI PT

MEDICARE: SALLY DRUDI PT
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 Therapist040-0002294VT

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
143V026OTHERVTMVP
2272927OTHERVTCIGNA
300008885OTHERVTBCBS
4MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1639258338
Entity Type Code : Individual
Provider Name (Legal Business Name) : SALLY DRUDI PT
Provider Business Mailing Address
First Line : 115 WELLNESS DR
Second Line :
City : WILLISTON
State : VT
Zip : 05495-2088
Country : US
Telephone Number : 802-860-1358
Fax Number : 802-860-1093
Provider Business Practice Location Address
First Line : 115 WELLNESS DR
Second Line :
City : WILLISTON
State : VT
Zip : 05495-2088
Country : US
Telephone Number : 802-860-1358
Fax Number : 802-860-1093
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/03/2006
Last Update Date : 05/06/2011

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Directions to “ SALLY DRUDI PT” Practice Location

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