Provider Demographics
NPI:1649831751
Name:MCARDLE, DELREY MARIE (PT)
Entity type:Individual
Prefix:
First Name:DELREY
Middle Name:MARIE
Last Name:MCARDLE
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:DELREY
Other - Middle Name:MARIE
Other - Last Name:MCARDLE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:190 COAL ST
Mailing Address - Street 2:
Mailing Address - City:NESQUEHONING
Mailing Address - State:PA
Mailing Address - Zip Code:18240-1203
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:426 W RAILROAD ST
Practice Address - Street 2:
Practice Address - City:NESQUEHONING
Practice Address - State:PA
Practice Address - Zip Code:18240-1414
Practice Address - Country:US
Practice Address - Phone:570-669-6580
Practice Address - Fax:570-669-9266
Is Sole Proprietor?:No
Enumeration Date:2019-06-28
Last Update Date:2019-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT005165L225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist