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NPI Code Detail

MEDICARE: BAYSIDE PHYSICAL THERAPY, L.L.C.

MEDICARE: BAYSIDE PHYSICAL THERAPY, L.L.C.
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 Therapist

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1K769OTHERDCBLUECHOICE
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3180CBAOTHERMDCAREFIRST

General Provider Information

NPI Number : 1912052309
Entity Type Code : Organization
Provider Name (Legal Business Name) : BAYSIDE PHYSICAL THERAPY, L.L.C.
Provider Business Mailing Address
First Line : 33195 LIGHTHOUSE RD
Second Line : SUITE 7
City : SELBYVILLE
State : DE
Zip : 19975-4071
Country : US
Telephone Number : 302-436-0901
Fax Number :
Provider Business Practice Location Address
First Line : 33195 LIGHTHOUSE RD
Second Line : SUITE 7
City : SELBYVILLE
State : DE
Zip : 19975-4071
Country : US
Telephone Number : 302-436-0901
Fax Number :
Authorized Official
Title or Position : PHYSICAL THERAPIST
Name : MRS. MICHELE YOVIENE
Credential : P.T.
Telephone Number : 410-829-5647
Provider Enumeration Date : 01/24/2007
Last Update Date : 05/15/2014

Similar Medicare Providers

1558323766 — CLAIRE DANIELLE BARTHELMESS MPT
Practice Location Address:
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SELBYVILLE, DE
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1659380087 — COASTAL PSYCHOLOGY AND EDUCATION ASSOCIATES, LLC
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1528518131 — BAYSIDE PHYSICAL THERAPY, LLC
Practice Location Address:
33195 LIGHTHOUSE RD , STE 7
SELBYVILLE, DE
19975-4071
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Practice Fax:
1104821198 — DR. MARC KATTELMAN D.O.
Practice Location Address:
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1922005255 — MRS. SALLY HAMEL DOWLING MD
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1043205628 — MRS. DEBORAH APOLLO SHEPARD FNP-C
Practice Location Address:
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Practice Fax:

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