Provider Demographics
NPI:1205822772
Name:BURKHART, GAYLE S (PHYSICAL THERAPIST)
Entity Type:Individual
Prefix:
First Name:GAYLE
Middle Name:S
Last Name:BURKHART
Suffix:
Gender:F
Credentials:PHYSICAL THERAPIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1243 S CEDAR CREST BLVD
Mailing Address - Street 2:
Mailing Address - City:ALLENTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18103-6268
Mailing Address - Country:US
Mailing Address - Phone:610-437-9880
Mailing Address - Fax:610-433-3605
Practice Address - Street 1:1243 S CEDAR CREST BLVD
Practice Address - Street 2:
Practice Address - City:ALLENTOWN
Practice Address - State:PA
Practice Address - Zip Code:18103-6268
Practice Address - Country:US
Practice Address - Phone:610-437-9880
Practice Address - Fax:610-433-3605
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-09-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT009689L225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA087216EDCMedicare UPIN