Provider Demographics
NPI:1003871922
Name:HALKO, WILLIAM JOSEPH (LPT)
Entity Type:Individual
Prefix:MR
First Name:WILLIAM
Middle Name:JOSEPH
Last Name:HALKO
Suffix:
Gender:M
Credentials:LPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8 OAK GROVE RD
Mailing Address - Street 2:STE 3
Mailing Address - City:PINE GROVE
Mailing Address - State:PA
Mailing Address - Zip Code:17963
Mailing Address - Country:US
Mailing Address - Phone:570-345-9966
Mailing Address - Fax:570-345-9988
Practice Address - Street 1:8 OAK GROVE RD
Practice Address - Street 2:STE 3
Practice Address - City:PINE GROVE
Practice Address - State:PA
Practice Address - Zip Code:17963
Practice Address - Country:US
Practice Address - Phone:570-345-9966
Practice Address - Fax:570-345-9988
Is Sole Proprietor?:No
Enumeration Date:2006-04-20
Last Update Date:2008-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT006945L225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA004695NSHOtherHIGHMARK MEDICARE SERVICES
PA01941101OtherCAPITAL ADVANTAGE
PA582618OtherPENNSYLVANIA BLUE SHIELD
PA01941101OtherCAPITAL BLUE CROSS/CAIC