Provider Demographics
NPI:1730116096
Name:SERATCH, FRANK III (MPT)
Entity Type:Individual
Prefix:
First Name:FRANK
Middle Name:
Last Name:SERATCH
Suffix:III
Gender:M
Credentials:MPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1076 VALLEY OF LKS
Mailing Address - Street 2:
Mailing Address - City:HAZLETON
Mailing Address - State:PA
Mailing Address - Zip Code:18202-9385
Mailing Address - Country:US
Mailing Address - Phone:570-384-1162
Mailing Address - Fax:570-384-1163
Practice Address - Street 1:1751 E BROAD ST
Practice Address - Street 2:
Practice Address - City:HAZLETON
Practice Address - State:PA
Practice Address - Zip Code:18201-5650
Practice Address - Country:US
Practice Address - Phone:570-459-4559
Practice Address - Fax:570-459-4558
Is Sole Proprietor?:No
Enumeration Date:2006-06-26
Last Update Date:2007-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADAPT000042225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA743930OtherHIGHMARK BLUE SHIELD
PA2482564OtherAETNA
PA018933580002Medicaid
PA50016498OtherCAPITAL BLUE CROSS
PA037585PHWMedicare ID - Type UnspecifiedMEDICARE PART B PROVIDER