Provider Demographics
NPI:1841054566
Name:BERKLOVICH, SAVANNAH MARIE (PTA)
Entity type:Individual
Prefix:
First Name:SAVANNAH
Middle Name:MARIE
Last Name:BERKLOVICH
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:231 LOWBER RD
Mailing Address - Street 2:
Mailing Address - City:FAYETTE CITY
Mailing Address - State:PA
Mailing Address - Zip Code:15438-1131
Mailing Address - Country:US
Mailing Address - Phone:724-366-7536
Mailing Address - Fax:
Practice Address - Street 1:6 NORTHGATE SQUARE
Practice Address - Street 2:
Practice Address - City:GREENSBURG
Practice Address - State:PA
Practice Address - Zip Code:15601
Practice Address - Country:US
Practice Address - Phone:724-832-8400
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-02-13
Last Update Date:2024-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PATEI006710225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant