Provider Demographics
NPI:1558424952
Name:CLASSIC PHYSICAL THERAPY AND REHAB CENTER INC
Entity Type:Organization
Organization Name:CLASSIC PHYSICAL THERAPY AND REHAB CENTER INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT PHYSICAL THERAPIST
Authorized Official - Prefix:MR
Authorized Official - First Name:DREW
Authorized Official - Middle Name:JOSEPH
Authorized Official - Last Name:BARNABEI
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:610-485-4403
Mailing Address - Street 1:3270 CHICHESTER AVE
Mailing Address - Street 2:
Mailing Address - City:BOOTHWYN
Mailing Address - State:PA
Mailing Address - Zip Code:19061-3250
Mailing Address - Country:US
Mailing Address - Phone:610-485-4403
Mailing Address - Fax:610-485-4430
Practice Address - Street 1:3270 CHICHESTER AVE
Practice Address - Street 2:
Practice Address - City:BOOTHWYN
Practice Address - State:PA
Practice Address - Zip Code:19061-3250
Practice Address - Country:US
Practice Address - Phone:610-485-4403
Practice Address - Fax:610-485-4430
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-18
Last Update Date:2007-11-21
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
PA2349425000OtherINDEPENDENCE BLUE CROSS
PA1672872OtherHIGHMARK BS
PA3271668OtherAETNA HMO
PA7981488OtherAETNA
PAP00227271OtherRAILROAD MEDICARE
PA087825Medicare PIN