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NPI Code Detail

MEDICARE: MR. MICHAEL BARTOLOMUCCI DPT

MEDICARE: MR. MICHAEL BARTOLOMUCCI 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
12251X0800XOrthopedic Physical TherapistPT023156PA

General Provider Information

NPI Number : 1952739880
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. MICHAEL BARTOLOMUCCI DPT
Provider Business Mailing Address
First Line : 120 W GERMANTOWN PIKE
Second Line : SUITE 100
City : PLYMOUTH MEETING
State : PA
Zip : 19462-1420
Country : US
Telephone Number : 610-270-0370
Fax Number : 610-270-0374
Provider Business Practice Location Address
First Line : 120 E LANCASTER AVE
Second Line : SUITE 106
City : ARDMORE
State : PA
Zip : 19003-3209
Country : US
Telephone Number : 484-297-6491
Fax Number : 610-896-7218
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/01/2013
Last Update Date : 11/01/2013

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