Provider Demographics
NPI:1164415337
Name:PERTES, STEVEN M (PT)
Entity Type:Individual
Prefix:
First Name:STEVEN
Middle Name:M
Last Name:PERTES
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:170 PHEASANT RUN
Mailing Address - Street 2:
Mailing Address - City:NEWTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18940-1821
Mailing Address - Country:US
Mailing Address - Phone:215-357-2000
Mailing Address - Fax:215-357-8499
Practice Address - Street 1:170 PHEASANT RUN
Practice Address - Street 2:
Practice Address - City:NEWTOWN
Practice Address - State:PA
Practice Address - Zip Code:18940-1821
Practice Address - Country:US
Practice Address - Phone:215-630-5172
Practice Address - Fax:215-579-7661
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-23
Last Update Date:2012-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT001534E225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA052313Medicare ID - Type Unspecified