Provider Demographics
NPI:1578093415
Name:GIVNISH, MARYCATHERINE (DPT)
Entity Type:Individual
Prefix:
First Name:MARYCATHERINE
Middle Name:
Last Name:GIVNISH
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:26 MONUMENT AVE
Mailing Address - Street 2:
Mailing Address - City:MALVERN
Mailing Address - State:PA
Mailing Address - Zip Code:19355-2625
Mailing Address - Country:US
Mailing Address - Phone:610-676-5860
Mailing Address - Fax:
Practice Address - Street 1:1600 BETHLEHEM PIKE
Practice Address - Street 2:
Practice Address - City:FLOURTOWN
Practice Address - State:PA
Practice Address - Zip Code:19031-2026
Practice Address - Country:US
Practice Address - Phone:215-233-9677
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-06-13
Last Update Date:2017-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT0262522251X0800X
PATPT0219352251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic