1851315345 NPI number — CMPT ASSOCIATES

Table of content: SARAH ADELINE HACKENBRACHT M.S. CCC-SLP (NPI 1841969078)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1851315345 NPI number — CMPT ASSOCIATES

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
CMPT ASSOCIATES
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:
MOHAWK PHYSICAL THERAPY
Provider Other Organization Name Type Code:
3
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:
1851315345
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/22/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
4 GREENVILLE ORTHOPEDIC CTR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
GREENVILLE
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
16125-1210
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
724-588-9680
Provider Business Mailing Address Fax Number:
724-588-9697

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3 E POLAND AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BESSEMER
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
16112-9109
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
724-667-1199
Provider Business Practice Location Address Fax Number:
724-667-1929
Provider Enumeration Date:
07/27/2006

Additional Information

Authorized Official

Authorized Official Last Name:
POWERS
Authorized Official First Name:
LAWRENCE
Authorized Official Middle Name:
RICHARD
Authorized Official Title or Position:
MANAGING PARTNER
Authorized Official Telephone Number:
724-588-9680

Provider Taxonomy Codes

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

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

  • Identifier: 0014933470010 , issued by the state of ( PA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 661191 . This is a "HIGHMARK" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".




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