Provider Demographics
NPI:1871532093
Name:MAYE, CAROLYN A (PT)
Entity type:Individual
Prefix:MS
First Name:CAROLYN
Middle Name:A
Last Name:MAYE
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3318 RODNEY DR
Mailing Address - Street 2:
Mailing Address - City:NEWTOWN SQUARE
Mailing Address - State:PA
Mailing Address - Zip Code:19073-4256
Mailing Address - Country:US
Mailing Address - Phone:610-325-1046
Mailing Address - Fax:
Practice Address - Street 1:3318 RODNEY DR
Practice Address - Street 2:
Practice Address - City:NEWTOWN SQUARE
Practice Address - State:PA
Practice Address - Zip Code:19073-4256
Practice Address - Country:US
Practice Address - Phone:610-325-1046
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT012417L225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAMA065076Medicare ID - Type UnspecifiedMEDICARE PROVIDER #