Provider Demographics
NPI:1477782803
Name:OSCAR, GWENDOLYN GRACE (LPTA)
Entity Type:Individual
Prefix:MRS
First Name:GWENDOLYN
Middle Name:GRACE
Last Name:OSCAR
Suffix:
Gender:F
Credentials:LPTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:173 NEW GARDEN RD
Mailing Address - Street 2:
Mailing Address - City:AVONDALE
Mailing Address - State:PA
Mailing Address - Zip Code:19311-9705
Mailing Address - Country:US
Mailing Address - Phone:610-268-8449
Mailing Address - Fax:
Practice Address - Street 1:173 NEW GARDEN RD
Practice Address - Street 2:
Practice Address - City:AVONDALE
Practice Address - State:PA
Practice Address - Zip Code:19311-9705
Practice Address - Country:US
Practice Address - Phone:610-268-8449
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-07
Last Update Date:2009-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PATEI002241225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant