Provider Demographics
NPI:1457726226
Name:VACCHIO, KAITLYNN MARIE (PT, DPT, CSCS)
Entity Type:Individual
Prefix:MRS
First Name:KAITLYNN
Middle Name:MARIE
Last Name:VACCHIO
Suffix:
Gender:F
Credentials:PT, DPT, CSCS
Other - Prefix:MS
Other - First Name:KAIRLYNN
Other - Middle Name:MARIE
Other - Last Name:TRZASKA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT, DPT, CSCS
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 1:1405A PENN AVE
Practice Address - Street 2:
Practice Address - City:WYOMISSING
Practice Address - State:PA
Practice Address - Zip Code:19610-2133
Practice Address - Country:US
Practice Address - Phone:610-396-9278
Practice Address - Fax:610-396-9242
Is Sole Proprietor?:No
Enumeration Date:2015-12-04
Last Update Date:2022-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2305212584225100000X
PAPT028999225100000X
NY039705-1225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist