Provider Demographics
NPI:1215206149
Name:LEWBART, BONNIE REBECCA (PT BS, PT MS)
Entity Type:Individual
Prefix:
First Name:BONNIE
Middle Name:REBECCA
Last Name:LEWBART
Suffix:
Gender:F
Credentials:PT BS, PT MS
Other - Prefix:
Other - First Name:BONNIE
Other - Middle Name:
Other - Last Name:FEINER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:1108-A N. BETHLEHEM PIKE
Mailing Address - Street 2:SUITE #1
Mailing Address - City:LOWER GWYNEDD
Mailing Address - State:PA
Mailing Address - Zip Code:19002
Mailing Address - Country:US
Mailing Address - Phone:215-628-0788
Mailing Address - Fax:215-628-2497
Practice Address - Street 1:1108-A N. BETHLEHEM PIKE
Practice Address - Street 2:SUITE #1
Practice Address - City:LOWER GWYNEDD
Practice Address - State:PA
Practice Address - Zip Code:19002
Practice Address - Country:US
Practice Address - Phone:215-628-0788
Practice Address - Fax:215-628-2497
Is Sole Proprietor?:No
Enumeration Date:2011-12-21
Last Update Date:2011-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT012276L225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist