Provider Demographics
NPI:1023010667
Name:NORTHEAST PT ASSOCIATES, INC.
Entity Type:Organization
Organization Name:NORTHEAST PT ASSOCIATES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SECRETARY-TREASURER
Authorized Official - Prefix:MR
Authorized Official - First Name:FRANK
Authorized Official - Middle Name:
Authorized Official - Last Name:SERATCH
Authorized Official - Suffix:III
Authorized Official - Credentials:MPT
Authorized Official - Phone:570-459-4559
Mailing Address - Street 1:1751 E BROAD ST
Mailing Address - Street 2:
Mailing Address - City:HAZLETON
Mailing Address - State:PA
Mailing Address - Zip Code:18201-5650
Mailing Address - Country:US
Mailing Address - Phone:570-459-4559
Mailing Address - Fax:570-459-4558
Practice Address - Street 1:1751 E BROAD ST
Practice Address - Street 2:
Practice Address - City:HAZLETON
Practice Address - State:PA
Practice Address - Zip Code:18201-5650
Practice Address - Country:US
Practice Address - Phone:570-459-4559
Practice Address - Fax:570-459-4558
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-08-12
Last Update Date:2007-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADAPT000042225100000X
PA225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA00053019OtherHIGHMARK BLUE SHIELD
PA2471582OtherCIGNA
PA2483752OtherAETNA
PA50002332OtherCAPITAL BLUE CROSS
PA812310OtherFIRST PRIORITY HEALTH
PA435084OtherHEALTH AMERICA
PA435084OtherHEALTH AMERICA