Provider Demographics
NPI:1376540666
Name:MILEN, RICK LEE (CPO, PTA)
Entity Type:Individual
Prefix:MR
First Name:RICK
Middle Name:LEE
Last Name:MILEN
Suffix:
Gender:M
Credentials:CPO, PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2211 QUARRY DR
Mailing Address - Street 2:STE E63
Mailing Address - City:WEST LAWN
Mailing Address - State:PA
Mailing Address - Zip Code:19609-1161
Mailing Address - Country:US
Mailing Address - Phone:610-678-1200
Mailing Address - Fax:610-678-0600
Practice Address - Street 1:2211 QUARRY DR
Practice Address - Street 2:STE E63
Practice Address - City:WEST LAWN
Practice Address - State:PA
Practice Address - Zip Code:19609-1161
Practice Address - Country:US
Practice Address - Phone:610-678-1200
Practice Address - Fax:610-678-0600
Is Sole Proprietor?:No
Enumeration Date:2005-07-01
Last Update Date:2008-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PACPO02528222Z00000X, 224P00000X
PATE001848L225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224P00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersProsthetist
No222Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOrthotist
No225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1640852OtherHIGHMARK
PA39HB05OtherCAPITAL BLUE CROSS
PA39HB05OtherCAPITAL BLUE CROSS