Provider Demographics
NPI:1679765242
Name:KOSMALA, ANITA (MPT)
Entity Type:Individual
Prefix:MRS
First Name:ANITA
Middle Name:
Last Name:KOSMALA
Suffix:
Gender:F
Credentials:MPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:141 N WOODBINE AVE
Mailing Address - Street 2:
Mailing Address - City:LANGHORNE
Mailing Address - State:PA
Mailing Address - Zip Code:19047-7426
Mailing Address - Country:US
Mailing Address - Phone:215-702-8141
Mailing Address - Fax:414-908-7368
Practice Address - Street 1:2629 TRENTON RD
Practice Address - Street 2:
Practice Address - City:LEVITTOWN
Practice Address - State:PA
Practice Address - Zip Code:19056-1428
Practice Address - Country:US
Practice Address - Phone:215-943-7777
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-08-16
Last Update Date:2007-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT009027L225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist