Provider Demographics
NPI:1740584713
Name:CARESTIA, BRYAN (PT, DPT, CSCS)
Entity Type:Individual
Prefix:
First Name:BRYAN
Middle Name:
Last Name:CARESTIA
Suffix:
Gender:M
Credentials:PT, DPT, CSCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4 TERRY DR STE 17H
Mailing Address - Street 2:
Mailing Address - City:NEWTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18940-1838
Mailing Address - Country:US
Mailing Address - Phone:267-566-1915
Mailing Address - Fax:
Practice Address - Street 1:4 TERRY DR STE 17H
Practice Address - Street 2:
Practice Address - City:NEWTOWN
Practice Address - State:PA
Practice Address - Zip Code:18940-1838
Practice Address - Country:US
Practice Address - Phone:267-566-1915
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-01-05
Last Update Date:2020-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist