Provider Demographics
NPI:1700035243
Name:ROBERTSON, CATHY LEE (PT)
Entity Type:Individual
Prefix:
First Name:CATHY
Middle Name:LEE
Last Name:ROBERTSON
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 1:240 PENN AVE
Mailing Address - Street 2:
Mailing Address - City:SCRANTON
Mailing Address - State:PA
Mailing Address - Zip Code:18503-1932
Mailing Address - Country:US
Mailing Address - Phone:570-558-0290
Mailing Address - Fax:570-558-0291
Practice Address - Street 1:240 PENN AVE
Practice Address - Street 2:
Practice Address - City:SCRANTON
Practice Address - State:PA
Practice Address - Zip Code:18503-1932
Practice Address - Country:US
Practice Address - Phone:570-558-0290
Practice Address - Fax:570-558-0291
Is Sole Proprietor?:No
Enumeration Date:2008-09-09
Last Update Date:2023-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL24247225100000X
PAPT007466L225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist