Provider Demographics
NPI:1598837064
Name:KLEBA, PAMELA MARIE
Entity Type:Individual
Prefix:MRS
First Name:PAMELA
Middle Name:MARIE
Last Name:KLEBA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:PAMELA
Other - Middle Name:MARIE
Other - Last Name:GERHARDT
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PT
Mailing Address - Street 1:200 LAFAYETTE DR
Mailing Address - Street 2:
Mailing Address - City:CRANBERRY TOWNSHIP
Mailing Address - State:PA
Mailing Address - Zip Code:16066-5738
Mailing Address - Country:US
Mailing Address - Phone:724-779-0080
Mailing Address - Fax:
Practice Address - Street 1:300 NORTHPOINTE CIR
Practice Address - Street 2:SUITE 101
Practice Address - City:SEVEN FIELDS
Practice Address - State:PA
Practice Address - Zip Code:16046-7862
Practice Address - Country:US
Practice Address - Phone:724-742-1250
Practice Address - Fax:724-742-1255
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT013990L225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist