Provider Demographics
NPI:1285763532
Name:WATSON, TERESA (DPT)
Entity type:Individual
Prefix:MS
First Name:TERESA
Middle Name:
Last Name:WATSON
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11 CAMBRIDGE LN
Mailing Address - Street 2:
Mailing Address - City:NEWTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18940-3326
Mailing Address - Country:US
Mailing Address - Phone:215-860-3623
Mailing Address - Fax:215-860-3763
Practice Address - Street 1:11 CAMBRIDGE LN
Practice Address - Street 2:
Practice Address - City:NEWTOWN
Practice Address - State:PA
Practice Address - Zip Code:18940-3326
Practice Address - Country:US
Practice Address - Phone:215-860-3623
Practice Address - Fax:215-860-3763
Is Sole Proprietor?:No
Enumeration Date:2007-03-05
Last Update Date:2016-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT018371225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ166743R5AMedicare PIN