Provider Demographics
NPI:1639933351
Name:CARBONE, WENDY (PT)
Entity Type:Individual
Prefix:
First Name:WENDY
Middle Name:
Last Name:CARBONE
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24 FOX RUN RD
Mailing Address - Street 2:
Mailing Address - City:MEDWAY
Mailing Address - State:MA
Mailing Address - Zip Code:02053-2242
Mailing Address - Country:US
Mailing Address - Phone:508-667-4444
Mailing Address - Fax:
Practice Address - Street 1:865 CENTRAL AVE
Practice Address - Street 2:
Practice Address - City:NEEDHAM
Practice Address - State:MA
Practice Address - Zip Code:02492-1316
Practice Address - Country:US
Practice Address - Phone:781-433-6440
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-02-13
Last Update Date:2024-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA9745225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist