Provider Demographics
NPI:1285902486
Name:VERTUDAZO, ALMA CHICOTE (OTR)
Entity type:Individual
Prefix:MS
First Name:ALMA
Middle Name:CHICOTE
Last Name:VERTUDAZO
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:707 RAMSEY CT
Mailing Address - Street 2:APT. 203
Mailing Address - City:SALISBURY
Mailing Address - State:MD
Mailing Address - Zip Code:21804-2777
Mailing Address - Country:US
Mailing Address - Phone:410-603-9631
Mailing Address - Fax:
Practice Address - Street 1:600 SOUTH BROOD ST.,
Practice Address - Street 2:GENESIS REHAB. SERVICES
Practice Address - City:KENNETT SQUARE
Practice Address - State:PA
Practice Address - Zip Code:19348
Practice Address - Country:US
Practice Address - Phone:410-641-9183
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-12-02
Last Update Date:2011-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD05297174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist