MEDICARE: MRS. MARY KAYE GIUDICI 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
1	225100000X	Physical Therapist	PT21457	CA

General Provider Information

NPI Number	:	1922160126
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. MARY KAYE GIUDICI MPT

Provider Business Mailing Address
First Line	:	250 HOSPITAL PARKWAY
Second Line	:
City	:	SAN JOSE
State	:	CA
Zip	:	95119-1100
Country	:	US
Telephone Number	:	408-972-7236
Fax Number	:	408-972-7548

Provider Business Practice Location Address
First Line	:	250 HOSPITAL PARKWAY
Second Line	:
City	:	SAN JOSE
State	:	CA
Zip	:	95119-1100
Country	:	US
Telephone Number	:	408-972-7236
Fax Number	:	408-972-7548

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

Provider Enumeration Date	:	12/14/2006
Last Update Date	:	02/11/2022

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