Provider Demographics
NPI:1891753471
Name:DEPERRO, CARRIE ANNE (MPT)
Entity Type:Individual
Prefix:MRS
First Name:CARRIE
Middle Name:ANNE
Last Name:DEPERRO
Suffix:
Gender:F
Credentials:MPT
Other - Prefix:MISS
Other - First Name:CARRIE
Other - Middle Name:ANNE
Other - Last Name:BUGGEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MPT
Mailing Address - Street 1:224 STRAWBRIDGE DR STE 100
Mailing Address - Street 2:
Mailing Address - City:MOORESTOWN
Mailing Address - State:NJ
Mailing Address - Zip Code:08057-4602
Mailing Address - Country:US
Mailing Address - Phone:856-677-4000
Mailing Address - Fax:856-234-3014
Practice Address - Street 1:790 PENLLYN BLUE BELL PIKE STE 101
Practice Address - Street 2:
Practice Address - City:BLUE BELL
Practice Address - State:PA
Practice Address - Zip Code:19422-1657
Practice Address - Country:US
Practice Address - Phone:267-458-4998
Practice Address - Fax:267-419-8761
Is Sole Proprietor?:No
Enumeration Date:2006-05-03
Last Update Date:2022-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT015398225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist