Provider Demographics
NPI:1114480084
Name:CASTALDI, MOIRA KELCEY (DPT)
Entity Type:Individual
Prefix:
First Name:MOIRA
Middle Name:KELCEY
Last Name:CASTALDI
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:MOIRA
Other - Middle Name:KELCEY
Other - Last Name:LANGAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DPT
Mailing Address - Street 1:350 NEW FIDELITY CT
Mailing Address - Street 2:
Mailing Address - City:GARNER
Mailing Address - State:NC
Mailing Address - Zip Code:27529-2665
Mailing Address - Country:US
Mailing Address - Phone:570-842-9323
Mailing Address - Fax:570-842-9362
Practice Address - Street 1:2591 ROUTE 6 STE 202
Practice Address - Street 2:
Practice Address - City:HAWLEY
Practice Address - State:PA
Practice Address - Zip Code:18428-7062
Practice Address - Country:US
Practice Address - Phone:570-226-5680
Practice Address - Fax:570-226-5682
Is Sole Proprietor?:No
Enumeration Date:2019-04-09
Last Update Date:2021-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT027499225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist