1114949252 NPI number — HANDS ON HEALING PHYSICAL THERAPY INC

Table of content: (NPI 1114949252)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1114949252 NPI number — HANDS ON HEALING PHYSICAL THERAPY INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
HANDS ON HEALING PHYSICAL THERAPY INC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1114949252
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
02/19/2015
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
16 MAYBROOK RD
Provider Second Line Business Mailing Address:
SUITE H
Provider Business Mailing Address City Name:
CAMPBELL HALL
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
10916-2743
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
845-636-4344
Provider Business Mailing Address Fax Number:
845-636-4355

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1040 SOUTH CEDAR CREST BLVD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ALLENTOWN
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
18103
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
610-821-9135
Provider Business Practice Location Address Fax Number:
610-821-5652
Provider Enumeration Date:
07/25/2006

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
ALBANESE
Authorized Official First Name:
CHRISTOPHER
Authorized Official Middle Name:
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
845-636-4344

Provider Taxonomy Codes

  • Taxonomy code: 225100000X , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 1523230 , issued by the state of ( PA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1766355 . This is a "HIGHMARK BLUE SHIELD" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 01618301 . This is a "CAPITAL BLUE CROSS" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".