Provider Demographics
NPI:1265412647
Name:KOVACH, KAREN MARIE (PT)
Entity type:Individual
Prefix:MRS
First Name:KAREN
Middle Name:MARIE
Last Name:KOVACH
Suffix:
Gender:F
Credentials:PT
Other - Prefix:MISS
Other - First Name:KAREN
Other - Middle Name:MARIE
Other - Last Name:KOHUT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1599 N HERMITAGE RD
Mailing Address - Street 2:
Mailing Address - City:HERMITAGE
Mailing Address - State:PA
Mailing Address - Zip Code:16148-3180
Mailing Address - Country:US
Mailing Address - Phone:724-962-7920
Mailing Address - Fax:724-962-6029
Practice Address - Street 1:1599 NORTH HERMITAGE RD
Practice Address - Street 2:
Practice Address - City:HERMITAGE
Practice Address - State:PA
Practice Address - Zip Code:16148
Practice Address - Country:US
Practice Address - Phone:724-962-7920
Practice Address - Fax:724-962-6029
Is Sole Proprietor?:No
Enumeration Date:2006-01-20
Last Update Date:2007-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT007617L225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA417748OtherHIGHMARK
PA417748OtherHIGHMARK
PA023778M45Medicare PIN