Provider Demographics
NPI:1609855584
Name:BAXENDELL, TROY (DPT)
Entity Type:Individual
Prefix:DR
First Name:TROY
Middle Name:
Last Name:BAXENDELL
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:376 SARATOGA DR
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15236-4455
Mailing Address - Country:US
Mailing Address - Phone:412-980-3125
Mailing Address - Fax:
Practice Address - Street 1:376 SARATOGA DR
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15236-4455
Practice Address - Country:US
Practice Address - Phone:412-980-3125
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-10
Last Update Date:2022-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD28516225100000X
FLPT37706225100000X
CT13167225100000X
VT040.0134292225100000X
NY047404225100000X
IN05014239A225100000X
DEJ1-0014444225100000X
NJ40QA02064300225100000X
MA25947225100000X
PADAPT001092225100000X
PAPT008591L225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA101130620Medicaid
PA101130620Medicaid