Provider Demographics
NPI:1417990706
Name:BARKANIC, JOLI (PT)
Entity type:Individual
Prefix:MISS
First Name:JOLI
Middle Name:
Last Name:BARKANIC
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 1:1805 LOUCKS RD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:YORK
Mailing Address - State:PA
Mailing Address - Zip Code:17408-7902
Mailing Address - Country:US
Mailing Address - Phone:717-764-0144
Mailing Address - Fax:717-764-0554
Practice Address - Street 1:1805 LOUCKS RD
Practice Address - Street 2:SUITE 200
Practice Address - City:YORK
Practice Address - State:PA
Practice Address - Zip Code:17408-7902
Practice Address - Country:US
Practice Address - Phone:717-764-0144
Practice Address - Fax:717-764-0554
Is Sole Proprietor?:No
Enumeration Date:2006-06-14
Last Update Date:2008-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT008368L225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA177124OtherMEDICARE HGS ADMINISTRATO
PA332313OtherHIGHMARK BLUE SHIELD
PA03182100OtherCAPITAL BLUE CROSS
PA0068377000OtherAMERIHEALTH UNDER IBC
PACK4276OtherPALMETTO GBA RR MEDICARE
PA18444OtherHEALTH AMERICA
PA0068377000OtherAMERIHEALTH UNDER IBC
PA332313OtherHIGHMARK BLUE SHIELD