Provider Demographics
NPI:1376657700
Name:YEARICK, ANNE WOOD (PT)
Entity type:Individual
Prefix:
First Name:ANNE
Middle Name:WOOD
Last Name:YEARICK
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 1:2035 HAMPSTEAD DR
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15235-5038
Mailing Address - Country:US
Mailing Address - Phone:412-244-0510
Mailing Address - Fax:
Practice Address - Street 1:13898 ROUTE 30
Practice Address - Street 2:
Practice Address - City:NORTH HUNTINGDON
Practice Address - State:PA
Practice Address - Zip Code:15642-2133
Practice Address - Country:US
Practice Address - Phone:724-861-6001
Practice Address - Fax:724-861-9155
Is Sole Proprietor?:No
Enumeration Date:2006-08-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADAPT000660174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA01828681Medicaid
PA5383525OtherAETNA/USHEALTHCARE PPO/PO
PA2792659OtherAETNA/USHEALTHCARE HMO/QP
PAYE828358OtherHIGHMARK BC/BS/KEYSTONE