Provider Demographics
NPI:1326149584
Name:PARSOTAM, PRITI (PT)
Entity Type:Individual
Prefix:MS
First Name:PRITI
Middle Name:
Last Name:PARSOTAM
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2775 SCHOENERSVILLE RD
Mailing Address - Street 2:
Mailing Address - City:BETHLEHEM
Mailing Address - State:PA
Mailing Address - Zip Code:18017-7307
Mailing Address - Country:US
Mailing Address - Phone:610-861-8080
Mailing Address - Fax:610-861-8080
Practice Address - Street 1:2414 MEADOW RIDGE DR
Practice Address - Street 2:
Practice Address - City:CHINO HILLS
Practice Address - State:CA
Practice Address - Zip Code:91709-1747
Practice Address - Country:US
Practice Address - Phone:909-217-6866
Practice Address - Fax:909-632-1280
Is Sole Proprietor?:No
Enumeration Date:2006-09-26
Last Update Date:2021-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT011377L225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
855007OtherHEALTH AMERICA/HEALTH ASSURANCE
2023286OtherHIGHMARK BLUE SHIELD
47241OtherGEISINGER HEALTH PLAN
7709482OtherAETNA PPO
50076788OtherCAPITAL BLUE CROSS
1863358OtherAETNA HMO
50076788OtherKEYSTONE HEALTH PLAN CENTRAL
50076788OtherCAPITAL BLUE CROSS