Provider Demographics
NPI:1336345966
Name:HANNA, REBECCA ELAINE (DPT)
Entity Type:Individual
Prefix:
First Name:REBECCA
Middle Name:ELAINE
Last Name:HANNA
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:221 MARTIN ST
Mailing Address - Street 2:
Mailing Address - City:BELLWOOD
Mailing Address - State:PA
Mailing Address - Zip Code:16617-2133
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:4133 MEDICAL CENTER DRIVE
Practice Address - Street 2:
Practice Address - City:BROAD TOP
Practice Address - State:PA
Practice Address - Zip Code:16621
Practice Address - Country:US
Practice Address - Phone:814-597-0028
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-06-21
Last Update Date:2010-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT018736225100000X
NJ40QA01333400225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist