Provider Demographics
NPI:1437811874
Name:ANGELUCCI, KELLY MARTHA (DPT)
Entity Type:Individual
Prefix:
First Name:KELLY
Middle Name:MARTHA
Last Name:ANGELUCCI
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 1:3298 MARCHANT DR
Mailing Address - Street 2:
Mailing Address - City:BETHLEHEM
Mailing Address - State:PA
Mailing Address - Zip Code:18017-1952
Mailing Address - Country:US
Mailing Address - Phone:484-515-6815
Mailing Address - Fax:
Practice Address - Street 1:1441 SCHOENERSVILLE RD
Practice Address - Street 2:
Practice Address - City:BETHLEHEM
Practice Address - State:PA
Practice Address - Zip Code:18018-1864
Practice Address - Country:US
Practice Address - Phone:484-526-7676
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-10-13
Last Update Date:2021-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist