Provider Demographics
NPI:1740287796
Name:SEIBERT, THERESA F (PT)
Entity type:Individual
Prefix:
First Name:THERESA
Middle Name:F
Last Name:SEIBERT
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 1:582 MIDDLETOWN BLVD
Mailing Address - Street 2:SUITE B100
Mailing Address - City:LANGHORNE
Mailing Address - State:PA
Mailing Address - Zip Code:19047-1828
Mailing Address - Country:US
Mailing Address - Phone:215-702-0600
Mailing Address - Fax:215-702-0610
Practice Address - Street 1:582 MIDDLETOWN BLVD
Practice Address - Street 2:SUITE B100
Practice Address - City:LANGHORNE
Practice Address - State:PA
Practice Address - Zip Code:19047-1828
Practice Address - Country:US
Practice Address - Phone:215-702-0600
Practice Address - Fax:215-702-0610
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-07-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT002500E225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1010280450001Medicaid
P02773Medicare UPIN
PA036444Medicare ID - Type Unspecified