Provider Demographics
NPI:1558447474
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:OWNER/PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:DREW
Authorized Official - Middle Name:J
Authorized Official - Last Name:BARNABEI
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:610-368-3937
Mailing Address - Street 1:525 W CHESTER PIKE
Mailing Address - Street 2:SUITE 104
Mailing Address - City:HAVERTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:19083
Mailing Address - Country:US
Mailing Address - Phone:610-626-9808
Mailing Address - Fax:610-626-9919
Practice Address - Street 1:525 W CHESTER PIKE
Practice Address - Street 2:SUITE 104
Practice Address - City:HAVERTOWN
Practice Address - State:PA
Practice Address - Zip Code:19083
Practice Address - Country:US
Practice Address - Phone:610-626-9808
Practice Address - Fax:610-626-9919
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-31
Last Update Date:2019-03-26
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
PA220830800OtherKEYSTONE HEALTHPLAN EAST
PA106131500OtherDEPT OF LABOR
PA1672872OtherHIGHMARK BLUE SHIELD
PAP00227271OtherRAILROAD MEDICARE
PA2349425000OtherINDEPENDENCE BLUE CROSS