Provider Demographics
NPI:1669404828
Name:REPKO, MEGAN M
Entity type:Individual
Prefix:MRS
First Name:MEGAN
Middle Name:M
Last Name:REPKO
Suffix:
Gender:F
Credentials:
Other - Prefix:MS
Other - First Name:MEGAN
Other - Middle Name:M
Other - Last Name:LEE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MPT
Mailing Address - Street 1:1806 SWAMP PIKE
Mailing Address - Street 2:SUITE 100
Mailing Address - City:GILBERTSVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:19525-9307
Mailing Address - Country:US
Mailing Address - Phone:610-327-2600
Mailing Address - Fax:610-327-9050
Practice Address - Street 1:1806 SWAMP PIKE
Practice Address - Street 2:SUITE 100
Practice Address - City:GILBERTSVILLE
Practice Address - State:PA
Practice Address - Zip Code:19525-9307
Practice Address - Country:US
Practice Address - Phone:610-327-2600
Practice Address - Fax:610-327-9050
Is Sole Proprietor?:No
Enumeration Date:2006-07-07
Last Update Date:2008-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT008104L225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1962428391OtherGROUP NPI
PARE1861407OtherHIGHMARK
PA2719331000OtherKEYSTONE/PC
PA102928T9DMedicare PIN