MEDICARE: BIANCA DANIELLE TRIO PT, DPT

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	047807-01	NY

General Provider Information

NPI Number	:	1669143905
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BIANCA DANIELLE TRIO PT, DPT

Provider Business Mailing Address
First Line	:	39 ALAN DR
Second Line	:
City	:	MAHOPAC
State	:	NY
Zip	:	10541-3303
Country	:	US
Telephone Number	:	914-539-1090
Fax Number	:

Provider Business Practice Location Address
First Line	:	388 WESTCHESTER AVE STE 1A
Second Line	:
City	:	PORT CHESTER
State	:	NY
Zip	:	10573-3623
Country	:	US
Telephone Number	:	914-939-6400
Fax Number	:

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

Provider Enumeration Date	:	09/27/2021
Last Update Date	:	09/30/2021

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