Provider Demographics
NPI:1275033656
Name:DESANCTIS, MARIKA (DPT)
Entity Type:Individual
Prefix:
First Name:MARIKA
Middle Name:
Last Name:DESANCTIS
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 183
Mailing Address - Street 2:
Mailing Address - City:SPRINGTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18081-0183
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2955 ADAMS WAY
Practice Address - Street 2:
Practice Address - City:RIEGELSVILLE
Practice Address - State:PA
Practice Address - Zip Code:18077
Practice Address - Country:US
Practice Address - Phone:484-735-3147
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-02-13
Last Update Date:2018-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251G0304XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGeriatrics