Provider Demographics
NPI:1538128590
Name:WHARRY, KAREN HOLTMAN (DPT)
Entity Type:Individual
Prefix:MRS
First Name:KAREN
Middle Name:HOLTMAN
Last Name:WHARRY
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:MISS
Other - First Name:KAREN
Other - Middle Name:MARIE
Other - Last Name:HOLTMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DPT
Mailing Address - Street 1:2730 ELLWOOD RD
Mailing Address - Street 2:
Mailing Address - City:NEW CASTLE
Mailing Address - State:PA
Mailing Address - Zip Code:16101-6276
Mailing Address - Country:US
Mailing Address - Phone:724-652-4334
Mailing Address - Fax:724-652-1491
Practice Address - Street 1:2730 ELLWOOD RD
Practice Address - Street 2:
Practice Address - City:NEW CASTLE
Practice Address - State:PA
Practice Address - Zip Code:16101-6276
Practice Address - Country:US
Practice Address - Phone:724-652-4334
Practice Address - Fax:724-652-1491
Is Sole Proprietor?:No
Enumeration Date:2006-03-20
Last Update Date:2013-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPTO16997225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1011639340001Medicaid
PAQ37560Medicare UPIN
088595P1AMedicare ID - Type Unspecified