Provider Demographics
NPI:1558655118
Name:PENN THERAPEUTIC INC
Entity Type:Organization
Organization Name:PENN THERAPEUTIC INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICAL MEDICINE & REHABILITATION
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:SANDLER
Authorized Official - Suffix:
Authorized Official - Credentials:ND LPN LMT
Authorized Official - Phone:267-287-3529
Mailing Address - Street 1:7767 MONTGOMERY AVE
Mailing Address - Street 2:
Mailing Address - City:ELKINS PARK
Mailing Address - State:PA
Mailing Address - Zip Code:19027-2612
Mailing Address - Country:US
Mailing Address - Phone:267-287-3529
Mailing Address - Fax:
Practice Address - Street 1:7764 MONTGOMERY AVE
Practice Address - Street 2:
Practice Address - City:ELKINS PARK
Practice Address - State:PA
Practice Address - Zip Code:19027-2612
Practice Address - Country:US
Practice Address - Phone:267-287-3529
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-06-01
Last Update Date:2014-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
164W00000X, 225100000X
PAMSG000140225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes164W00000XNursing Service ProvidersLicensed Practical NurseGroup - Single Specialty
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
No225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Single Specialty