MEDICARE: MELISSA ESCUDERO 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	CP-048813T	DE
2	225100000X	Physical Therapist	2305216341	VA

General Provider Information

NPI Number	:	1740034354
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MELISSA ESCUDERO PT, DPT

Provider Business Mailing Address
First Line	:	4021 7TH ST NE APT 2
Second Line	:
City	:	WASHINGTON
State	:	DC
Zip	:	20017-1931
Country	:	US
Telephone Number	:	404-483-3372
Fax Number	:

Provider Business Practice Location Address
First Line	:	2923C E LEE AVE
Second Line	:
City	:	ALEXANDRIA
State	:	VA
Zip	:	22306-1721
Country	:	US
Telephone Number	:	703-717-7659
Fax Number	:

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

Provider Enumeration Date	:	04/11/2024
Last Update Date	:	01/20/2026

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