Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225100000X | Physical Therapist | PT005493L | PA |
N | 2251S0007X | Physical Therapist - Sports | PT005493L | PA |
N | 2251X0800X | Physical Therapist - Orthopedic | PT005493L | PA |
NPI | 1215923461 |
---|---|
Provider Name | Craig Carvin |
First Address | Boston, MA 02284-8269 |
Second Address | Allentown, PA 18104-9168 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/09/2005 |
Last Update Date | 31/07/2009 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0052130 | ORTHONET (01) | PA |
01345801 | BLUE CROSS (01) | PA |
01345801 | KEYSTONE CENTRAL (01) | PA |
088295 | MEDICARE (01) | PA |
4608845 | AETNA (01) | PA |
467798 | BLUE SHIELD (01) | PA |
467798 | FIRST PRIORITY LIFE (01) | PA |
467798 | PERSONAL CHOICE (01) | PA |