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NPI Code Detail

MEDICARE: ZACHARY PAUL BENEVIDES MPT

MEDICARE:   ZACHARY PAUL BENEVIDES  MPT
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 TherapistPT015304PA

General Provider Information

NPI Number : 1881652113
Entity Type Code : Individual
Provider Name (Legal Business Name) : ZACHARY PAUL BENEVIDES MPT
Provider Business Mailing Address
First Line : 902 CHERRY WOOD CT
Second Line :
City : PHOENIXVILLE
State : PA
Zip : 19460-4851
Country : US
Telephone Number : 215-767-7103
Fax Number :
Provider Business Practice Location Address
First Line : 2 DEVON SQ
Second Line : 744 W. LANCASTER AVENUE
City : WAYNE
State : PA
Zip : 19087-2523
Country : US
Telephone Number : 610-688-7776
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/03/2006
Last Update Date : 07/08/2007

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Directions to “ ZACHARY PAUL BENEVIDES MPT” Practice Location

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