Provider Demographics
NPI:1528038809
Name:CORNERSTONE PHYSICAL THERAPY ASSOCIATES, LLC
Entity Type:Organization
Organization Name:CORNERSTONE PHYSICAL THERAPY ASSOCIATES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:ANDREA
Authorized Official - Middle Name:
Authorized Official - Last Name:PRICE
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:215-633-9080
Mailing Address - Street 1:1 WOODHAVEN MALL
Mailing Address - Street 2:SUITE 203
Mailing Address - City:BENSALEM
Mailing Address - State:PA
Mailing Address - Zip Code:19020-5607
Mailing Address - Country:US
Mailing Address - Phone:215-633-9080
Mailing Address - Fax:215-633-9950
Practice Address - Street 1:1 WOODHAVEN MALL
Practice Address - Street 2:SUITE 203
Practice Address - City:BENSALEM
Practice Address - State:PA
Practice Address - Zip Code:19020-5607
Practice Address - Country:US
Practice Address - Phone:215-633-9080
Practice Address - Fax:215-633-9950
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-01-26
Last Update Date:2007-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PACH8924OtherTRAVELERS MEDICARE
789312OtherHIGHMARK BS
PACH8924OtherTRAVELERS MEDICARE