Provider Demographics
NPI:1922247295
Name:USUKA, ANNE J (MPT)
Entity Type:Individual
Prefix:
First Name:ANNE
Middle Name:J
Last Name:USUKA
Suffix:
Gender:F
Credentials:MPT
Other - Prefix:
Other - First Name:ANNE
Other - Middle Name:J
Other - Last Name:FURMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MPT
Mailing Address - Street 1:178 SCHUYLKILL MOUNTAIN RD
Mailing Address - Street 2:
Mailing Address - City:SCHUYLKILL HAVEN
Mailing Address - State:PA
Mailing Address - Zip Code:17972-8934
Mailing Address - Country:US
Mailing Address - Phone:570-739-2637
Mailing Address - Fax:
Practice Address - Street 1:24 HIKES HOLLOW RD
Practice Address - Street 2:WATERBRIDGE AT PINE GROVE
Practice Address - City:PINE GROVE
Practice Address - State:PA
Practice Address - Zip Code:17963-9200
Practice Address - Country:US
Practice Address - Phone:570-345-8350
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-02-11
Last Update Date:2009-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT007088L225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist