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NPI Code Detail

MEDICARE: CHRISTOPHER GREGORY CARLUCCI RPTA

MEDICARE:   CHRISTOPHER GREGORY CARLUCCI  RPTA
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
1225200000XPhysical Therapy AssistantA1162MD

General Provider Information

NPI Number : 1700169794
Entity Type Code : Individual
Provider Name (Legal Business Name) : CHRISTOPHER GREGORY CARLUCCI RPTA
Provider Business Mailing Address
First Line : 3226 GUILFORD DR
Second Line :
City : WALDORF
State : MD
Zip : 20602-2586
Country : US
Telephone Number : 301-645-9495
Fax Number :
Provider Business Practice Location Address
First Line : 12021 LIVINGSTON RD
Second Line :
City : FORT WASHINGTON
State : MD
Zip : 20744-4210
Country : US
Telephone Number : 301-292-0300
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/26/2011
Last Update Date : 09/26/2011

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Directions to “ CHRISTOPHER GREGORY CARLUCCI RPTA” Practice Location

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