1720302623 NPI number — MRS. KRISTA E NATALE PHYSICAL THERAPY

Table of content: MRS. KRISTA E NATALE PHYSICAL THERAPY (NPI 1720302623)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1720302623 NPI number — MRS. KRISTA E NATALE PHYSICAL THERAPY

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
NATALE
Provider First Name:
KRISTA
Provider Middle Name:
E
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
PHYSICAL THERAPY
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
LITZINGER
Provider Other First Name:
KRISTA
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
PHYSICAL THERAPY
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1720302623
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
12/22/2015
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
625 LINCOLN AVE SUITE 107
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
N. CHARLEROI
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
15022
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
724-483-3610
Provider Business Mailing Address Fax Number:
724-489-4758

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
605 SCENERY DRIVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ELIZABETH
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
15037
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
412-751-0040
Provider Business Practice Location Address Fax Number:
412-751-0041
Provider Enumeration Date:
03/22/2010

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 225100000X , with the licence number:  PT020401 , 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: 102484354 , issued by the state of ( PA ) . This identifiers is of the category "MEDICAID".




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