Provider Demographics
NPI:1295097400
Name:NEFF, KYRA (PTA)
Entity type:Individual
Prefix:
First Name:KYRA
Middle Name:
Last Name:NEFF
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:163 MELROSE RD
Mailing Address - Street 2:
Mailing Address - City:SUSQUEHANNA
Mailing Address - State:PA
Mailing Address - Zip Code:18847-7986
Mailing Address - Country:US
Mailing Address - Phone:410-259-1080
Mailing Address - Fax:
Practice Address - Street 1:163 MELROSE RD
Practice Address - Street 2:
Practice Address - City:SUSQUEHANNA
Practice Address - State:PA
Practice Address - Zip Code:18847-7986
Practice Address - Country:US
Practice Address - Phone:410-259-1080
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-13
Last Update Date:2012-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PATEI003243225200000X
MDA3628225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant