Provider Demographics
NPI:1407801376
Name:WILGEROTH, EUGENIA E (PHYSICAL THERAPIST)
Entity Type:Individual
Prefix:MRS
First Name:EUGENIA
Middle Name:E
Last Name:WILGEROTH
Suffix:
Gender:F
Credentials:PHYSICAL THERAPIST
Other - Prefix:MS
Other - First Name:EUGENIA
Other - Middle Name:E
Other - Last Name:PANAGEAS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHYSICAL THERAPIST
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:610-861-0854
Practice Address - Street 1:3101 EMRICK BLVD
Practice Address - Street 2:SUITE 112
Practice Address - City:BETHLEHEM
Practice Address - State:PA
Practice Address - Zip Code:18020-8021
Practice Address - Country:US
Practice Address - Phone:610-997-5750
Practice Address - Fax:610-997-5762
Is Sole Proprietor?:No
Enumeration Date:2006-05-22
Last Update Date:2011-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT002363E225100000X
NJQA04405225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
039341Medicare ID - Type Unspecified