Provider Demographics
NPI:1457836124
Name:CACCAVALE, PAULA CRISTINA (DPT)
Entity type:Individual
Prefix:
First Name:PAULA
Middle Name:CRISTINA
Last Name:CACCAVALE
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3204 TOWER OAKS BLVD STE 150
Mailing Address - Street 2:
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20852-4211
Mailing Address - Country:US
Mailing Address - Phone:301-468-9343
Mailing Address - Fax:301-230-2127
Practice Address - Street 1:3204 TOWER OAKS BLVD STE 150
Practice Address - Street 2:
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20852-4211
Practice Address - Country:US
Practice Address - Phone:301-468-9343
Practice Address - Fax:301-230-2127
Is Sole Proprietor?:No
Enumeration Date:2018-09-28
Last Update Date:2024-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD27210225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist