Provider Demographics
NPI:1245564533
Name:HASENPLUG, MICHAEL (PTA)
Entity Type:Individual
Prefix:MR
First Name:MICHAEL
Middle Name:
Last Name:HASENPLUG
Suffix:
Gender:M
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1750 NEW BUTLER RD
Mailing Address - Street 2:
Mailing Address - City:NEW CASTLE
Mailing Address - State:PA
Mailing Address - Zip Code:16101-3184
Mailing Address - Country:US
Mailing Address - Phone:724-856-3268
Mailing Address - Fax:724-498-4333
Practice Address - Street 1:1750 NEW BUTLER RD
Practice Address - Street 2:
Practice Address - City:NEW CASTLE
Practice Address - State:PA
Practice Address - Zip Code:16101-3184
Practice Address - Country:US
Practice Address - Phone:724-856-3268
Practice Address - Fax:724-498-4333
Is Sole Proprietor?:Yes
Enumeration Date:2009-09-20
Last Update Date:2009-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PATE008202225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant