Provider Demographics
NPI:1184458085
Name:CALUNGSUD, TROY (PT, DPT)
Entity type:Individual
Prefix:
First Name:TROY
Middle Name:
Last Name:CALUNGSUD
Suffix:
Gender:M
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12801 PEGASI WAY
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27614-8382
Mailing Address - Country:US
Mailing Address - Phone:848-391-0442
Mailing Address - Fax:
Practice Address - Street 1:12801 PEGASI WAY
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27614-8382
Practice Address - Country:US
Practice Address - Phone:848-391-0442
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-09-02
Last Update Date:2024-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP11382225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist