Provider Demographics
NPI:1336132836
Name:KRASNIAK, CATHY MARY (PTA)
Entity Type:Individual
Prefix:
First Name:CATHY
Middle Name:MARY
Last Name:KRASNIAK
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:CATH
Other - Middle Name:MARY
Other - Last Name:HESSLING
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:232 SUNRISE AVE
Mailing Address - Street 2:
Mailing Address - City:HONESDALE
Mailing Address - State:PA
Mailing Address - Zip Code:18431-1085
Mailing Address - Country:US
Mailing Address - Phone:570-251-8003
Mailing Address - Fax:570-251-8005
Practice Address - Street 1:232 SUNRISE AVE
Practice Address - Street 2:
Practice Address - City:HONESDALE
Practice Address - State:PA
Practice Address - Zip Code:18431-1085
Practice Address - Country:US
Practice Address - Phone:570-251-8003
Practice Address - Fax:570-251-8005
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-08-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PATE006722225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant