Provider Demographics
NPI:1780629212
Name:BITONTI, TRESSA (PT)
Entity Type:Individual
Prefix:MS
First Name:TRESSA
Middle Name:
Last Name:BITONTI
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:625 LINCOLN AVE
Mailing Address - Street 2:PROFESSIONAL PLAZA SUITE 107
Mailing Address - City:CHARLEROI
Mailing Address - State:PA
Mailing Address - Zip Code:15022-2451
Mailing Address - Country:US
Mailing Address - Phone:724-483-4886
Mailing Address - Fax:724-483-0519
Practice Address - Street 1:625 LINCOLN AVE
Practice Address - Street 2:PROFESSIONAL PLAZA SUITE 107
Practice Address - City:CHARLEROI
Practice Address - State:PA
Practice Address - Zip Code:15022-2451
Practice Address - Country:US
Practice Address - Phone:724-483-4886
Practice Address - Fax:724-483-0519
Is Sole Proprietor?:No
Enumeration Date:2006-06-18
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT006180L225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0015935850001Medicaid
PA396610Medicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER