Provider Demographics
NPI:1467740522
Name:GADLEY, LYNDSAY E (DPT)
Entity Type:Individual
Prefix:
First Name:LYNDSAY
Middle Name:E
Last Name:GADLEY
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 1:800 W PENN PINES BLVD
Mailing Address - Street 2:
Mailing Address - City:ALDAN
Mailing Address - State:PA
Mailing Address - Zip Code:19018-4311
Mailing Address - Country:US
Mailing Address - Phone:267-650-3940
Mailing Address - Fax:
Practice Address - Street 1:5008 BALTIMORE AVENUE 2ND FLOOR, SUITE D
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19143
Practice Address - Country:US
Practice Address - Phone:215-650-7383
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-07-11
Last Update Date:2016-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT021416225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1528438793OtherNPI - VITAL STEP PHYSICAL THERAPY & FITNESS, P.C.
PA47-4506800OtherTAX ID - VITAL STEP PHYSICAL THERAPY & FITNESS, P.C.
PA47-4506800OtherTAX ID - VITAL STEP PHYSICAL THERAPY & FITNESS, P.C.