1861763112 NPI number — KINESIS PHYSICAL THERAPY

Table of content: (NPI 1861763112)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1861763112 NPI number — KINESIS PHYSICAL THERAPY

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
KINESIS PHYSICAL THERAPY
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:
1861763112
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
09/01/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1201 BROUGHTON RD STE 203
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
PITTSBURGH
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
15236-3451
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
412-892-5650
Provider Business Mailing Address Fax Number:
412-892-5651

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
5241 BROWNSVILLE RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
PITTSBURGH
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
15236-2756
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
412-892-5650
Provider Business Practice Location Address Fax Number:
412-892-5651
Provider Enumeration Date:
01/18/2012

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
EBERLEY
Authorized Official First Name:
CHRISTOPHER
Authorized Official Middle Name:
JAMES
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
412-667-8574

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)