MEDICARE: DR. KATHY NICHOLE PIELA 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	24549	MA

General Provider Information

NPI Number	:	1871141002
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. KATHY NICHOLE PIELA PT, DPT

Provider Business Mailing Address
First Line	:	246 INDEPENDENCE DR
Second Line	:
City	:	CHESTNUT HILL
State	:	MA
Zip	:	02467-3664
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	337 NEPONSET AVE
Second Line	:
City	:	DORCHESTER
State	:	MA
Zip	:	02122-3103
Country	:	US
Telephone Number	:	716-265-2350
Fax Number	:

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

Provider Enumeration Date	:	08/30/2019
Last Update Date	:	08/30/2019

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