Basic Information
Provider Information
NPI: 1790425528
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: CECCHINI
FirstName: CHLOE
MiddleName:  
NamePrefix: DR.
NameSuffix:  
Credential:  
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 3844 OCEAN TIDES DR
Address2:  
City: VIRGINIA BEACH
State: VA
PostalCode: 234552916
CountryCode: US
TelephoneNumber: 4782136365
FaxNumber:  
Practice Location
Address1: 828 HEALTHY WAY STE 110
Address2:  
City: VIRGINIA BEACH
State: VA
PostalCode: 234627958
CountryCode: US
TelephoneNumber: 7573951960
FaxNumber:  
Other Information
ProviderEnumerationDate: 03/30/2022
LastUpdateDate: 07/13/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 07/13/2022

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
225100000X2305214135VAN Respiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist 
225100000X  Y Respiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist 

No ID Information.


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