Provider Demographics
NPI:1003829219
Name:CONTINO, CARL C (MS, PT)
Entity Type:Individual
Prefix:MR
First Name:CARL
Middle Name:C
Last Name:CONTINO
Suffix:
Gender:M
Credentials:MS, PT
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1413 W MOYAMENSING AVE
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19145-4625
Mailing Address - Country:US
Mailing Address - Phone:267-639-2555
Mailing Address - Fax:267-639-2632
Practice Address - Street 1:1413 W MOYAMENSING AVE
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19145-4625
Practice Address - Country:US
Practice Address - Phone:267-639-2555
Practice Address - Fax:267-639-2632
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-15
Last Update Date:2012-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT-013787-L225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist