MS. MARIE CUSTODERO (NPI# 1871714998) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1871714998 |
| Entity Type | Individual |
| Full Name | MS. MARIE CUSTODERO |
| Credential | P.T. |
| Practice Address |
550 Eastgate Dr Aiken SC 29803 |
| Mailing Address |
4 W Red Oak Ln Ste 201 White Plains NY 10604-3603 |
| Practice Telephone | 8036433694 |
| Enumeration Date | 2007-05-02 |
| Last Update Date | 2019-09-11 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2251G0304X |
Physical Therapist Specialization: Geriatrics |
Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | 887462000 | 05 |
| Street Address |
550 EASTGATE DR |
| City | AIKEN |
| State | SC |
| Zip Code | 29803 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326007097 | Michael Alan Faircloth | Family Medicine | 550 Eastgate Dr, Aiken, SC 29803-7688 | 2006-03-21 |
| 1952914947 | Emily Gowan | Speech-Language Pathologist | 550 Eastgate Dr, Aiken, SC 29803-7688 | 2020-08-28 |
| 1831716455 | Mason Spratling | Physical Therapist | 550 Eastgate Dr, Aiken, SC 29803-7688 | 2020-06-30 |
| 1316578636 | Amanda Montez Aiken | Occupational Therapy Assistant | 550 Eastgate Dr, Aiken, SC 29803-7688 | 2020-01-27 |
| 1871062844 | Piper Walker | Occupational Therapist | 550 Eastgate Dr, Aiken, SC 29803-7688 | 2018-11-19 |
| 1134697832 | Sc-ga2018 Anchor Rehabilitation and Healthcare Center of Aiken, LLC | Skilled Nursing Facility | 550 Eastgate Dr, Aiken, SC 29803-7688 | 2018-11-12 |
| 1750857231 | Cara Priest | Physical Medicine & Rehabilitation | 550 Eastgate Dr, Aiken, SC 29803-7688 | 2018-10-22 |
| 1225526098 | Michael Joseph Schwab | Occupational Therapist | 550 Eastgate Dr, Aiken, SC 29803-7688 | 2018-04-27 |
| 1720390883 | Anchor Rehabilitation and Healthcare Center of Aiken, LLC | Skilled Nursing Facility | 550 Eastgate Dr, Aiken, SC 29803-7688 | 2010-07-06 |
| 1932125440 | Carriage Hills Living Center, LLC | Skilled Nursing Facility | 550 Eastgate Dr, Aiken, SC 29803-7688 | 2006-07-15 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871147454 | Augusta Oncology Associates, P.C. | Specialist | 222 University Parkway, Aiken, SC 29803 | 2019-07-31 |
| 1356804546 | Ebony Johnson | Home Health Aide | 942 C Dougherty Rd, Aiken, SC 29803 | 2019-04-13 |
| 1689144230 | Tabatha Lee Maddox | Occupational Therapist | 550 East Gate Dr, Aiken, SC 29803 | 2018-11-27 |
| 1962995100 | Pvd Internal Medicine Associates LLC | Internal Medicine | 440 Society Hill Dr Ste B, Aiken, SC 29803 | 2018-06-12 |
| 1689197691 | Trent David Yoder | Dentist | 174 Crepe Myrtle Drive, Aiken, SC 29803 | 2017-07-21 |
| 1770039331 | Lauren Reigot | Physical Therapist | 6140 Woodside Executive Ct., Aiken, SC 29803 | 2016-09-01 |
| 1851747190 | Umg Primary Care South Carolina, LLC | Family Medicine | 1023 Silver Bluff Road, Aiken, SC 29803 | 2016-05-05 |
| 1912375759 | Lisa G Browning | Nurse Practitioner | 550 E. Gate Drive, Aiken, SC 29803 | 2015-09-10 |
| 1346682754 | Tyresia Jovon White | Dentist | 440 Society Hill Dr Ste 201, Aiken, SC 29803 | 2013-07-25 |
| 1528327483 | Caresouth Hospice, LLC | Hospice Care, Community Based | 37 Varden Drive, Suite B, Aiken, SC 29803 | 2012-05-14 |
| Find all providers in zip 29803 | ||||
| Taxonomy Code | 2251G0304X |
| Grouping | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Classification | Physical Therapist |
| Specialization | Geriatrics |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770931172 | Alida Mcgann | Physical Therapist | 206 Robinson St, Greenville, SC 29609-5433 | 2016-05-26 |
| 1992178644 | Michael Gerard Brophy | Physical Therapist | 811 Woodstone Dr, Apt G, Florence, SC 29501-5502 | 2015-11-03 |
| 1366833279 | Cindy Matthews-long | Physical Therapist | 828 Beltline Blvd, Columbia, SC 29205-2063 | 2015-02-13 |
| 1114321965 | Teresa Marie Jemming | Physical Therapist | 3300 Butterworth Cir, Sumter, SC 29154-9475 | 2014-10-21 |
| 1750784138 | Patrice Hazan | Physical Therapist | 845 Ne Main St, Simpsonville, SC 29681-2041 | 2014-09-30 |
| 1396007407 | Michele Acejo Bucayan | Physical Therapist | 335 Midland Pkwy, Summerville, SC 29485-8138 | 2012-06-14 |
| 1972885754 | Jacob Pierce Fleming | Physical Therapist | 27 Barnwood Cir, Greenville, SC 29607-5486 | 2011-09-16 |
| 1942594544 | Tp Holdings, LLC | Physical Therapist | 1795 N Highway 17, Suite 5, Mount Pleasant, SC 29464-3631 | 2011-06-01 |
| 1659518975 | Visio Perspectives Neuro Rehab Services LLC | Physical Therapist | 115 S Morris St, Lake City, SC 29560-2459 | 2009-01-08 |
| 1538329941 | Joshua J Canfield | Physical Therapist | 112 Tanglesworth Rd, Irmo, SC 29063-7905 | 2008-06-10 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.