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NPI Code Detail

MEDICARE: MRS. TINA MARIE CAMPBELL PT

MEDICARE: MRS. TINA MARIE CAMPBELL 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 Therapist0101461NY

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1821071788
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. TINA MARIE CAMPBELL PT
Provider Business Mailing Address
First Line : 42 SARATOGA RD
Second Line :
City : SCOTIA
State : NY
Zip : 12302-3412
Country : US
Telephone Number : 518-399-6861
Fax Number : 518-399-6864
Provider Business Practice Location Address
First Line : 42 SARATOGA RD
Second Line :
City : SCOTIA
State : NY
Zip : 12302-3412
Country : US
Telephone Number : 518-399-6861
Fax Number : 518-399-6864
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/23/2005
Last Update Date : 07/08/2007

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Directions to “ MRS. TINA MARIE CAMPBELL PT” Practice Location

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