Provider Demographics
NPI:1184652471
Name:AARON, MARK (PT)
Entity Type:Individual
Prefix:MR
First Name:MARK
Middle Name:
Last Name:AARON
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 1:1145 BOWER HILL RD
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15243-1342
Mailing Address - Country:US
Mailing Address - Phone:412-276-6637
Mailing Address - Fax:412-276-2205
Practice Address - Street 1:1145 BOWER HILL RD
Practice Address - Street 2:#302
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15243-1342
Practice Address - Country:US
Practice Address - Phone:412-276-6637
Practice Address - Fax:412-276-2205
Is Sole Proprietor?:No
Enumeration Date:2006-06-28
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT003827L225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA015935850003Medicaid
PA396610Medicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER