Basic Information
| Provider Information | |||||||||
| NPI: | 1881943348 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | MALONEY | ||||||||
| FirstName: | CASEY | ||||||||
| MiddleName: | K | ||||||||
| NamePrefix: | MS. | ||||||||
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| Credential: | PT DPT | ||||||||
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| Mailing Information | |||||||||
| Address1: | 331 COTUIT RD | ||||||||
| Address2: | BUILDING 1 UNIT 4 | ||||||||
| City: | SANDWICH | ||||||||
| State: | MA | ||||||||
| PostalCode: | 025632434 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5088889288 | ||||||||
| FaxNumber: | 5088886288 | ||||||||
| Practice Location | |||||||||
| Address1: | 1 AUSTON RD | ||||||||
| Address2: | SUITE A | ||||||||
| City: | EAST HARWICH | ||||||||
| State: | MA | ||||||||
| PostalCode: | 026451385 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5084325760 | ||||||||
| FaxNumber: | 5084325829 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/30/2012 | ||||||||
| LastUpdateDate: | 04/07/2015 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225100000X | 035459 | NY | N | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist | 225100000X | 20276 | MA | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist |
No ID Information.