1861207730 NPI number — DIANA DELANY KANYARUSOKE PT, DPT

Table of content: DIANA DELANY KANYARUSOKE PT, DPT (NPI 1861207730)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1861207730 NPI number — DIANA DELANY KANYARUSOKE PT, DPT

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
KANYARUSOKE
Provider First Name:
DIANA
Provider Middle Name:
DELANY
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
PT, DPT
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
WATSON
Provider Other First Name:
DIANA
Provider Other Middle Name:
DELANY
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
PT, DPT
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1861207730
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
02/10/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1033 COUNTRY CLUB RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
JEANNETTE
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
15644-4721
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
724-549-8071
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2526 MONROEVILLE BLVD STE 3
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MONROEVILLE
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
15146-2358
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
412-457-8200
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
02/10/2025

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:  PT030071 , 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)





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