Provider Demographics
NPI:1982010047
Name:ADRIAN, CARMEN (PT)
Entity Type:Individual
Prefix:MR
First Name:CARMEN
Middle Name:
Last Name:ADRIAN
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1677 STATE ROUTE 65
Mailing Address - Street 2:
Mailing Address - City:ELLWOOD CITY
Mailing Address - State:PA
Mailing Address - Zip Code:16117
Mailing Address - Country:US
Mailing Address - Phone:724-752-2716
Mailing Address - Fax:724-752-0990
Practice Address - Street 1:2610 ELLWOOD RD
Practice Address - Street 2:
Practice Address - City:NEW CASTLE
Practice Address - State:PA
Practice Address - Zip Code:16101-6218
Practice Address - Country:US
Practice Address - Phone:724-202-6971
Practice Address - Fax:724-202-6612
Is Sole Proprietor?:No
Enumeration Date:2014-07-09
Last Update Date:2014-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT003144L225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist