Provider Demographics
NPI:1891359113
Name:VAYO, CARINA (PTA)
Entity type:Individual
Prefix:
First Name:CARINA
Middle Name:
Last Name:VAYO
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:CARINA
Other - Middle Name:
Other - Last Name:PLUMLEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PTA
Mailing Address - Street 1:4633 GRIFFIN DR
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:DE
Mailing Address - Zip Code:19808-4113
Mailing Address - Country:US
Mailing Address - Phone:302-388-4133
Mailing Address - Fax:
Practice Address - Street 1:4949 OGLETOWN STANTON RD
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:DE
Practice Address - Zip Code:19713-2068
Practice Address - Country:US
Practice Address - Phone:302-998-6900
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-04-23
Last Update Date:2019-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEJ2-0000816225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant