Provider Demographics
NPI:1841270808
Name:SYERSAK-MURCKO, REBECCA LYNN (PT)
Entity type:Individual
Prefix:MRS
First Name:REBECCA
Middle Name:LYNN
Last Name:SYERSAK-MURCKO
Suffix:
Gender:F
Credentials:PT
Other - Prefix:MISS
Other - First Name:REBECCA
Other - Middle Name:LYNN
Other - Last Name:MARKWORTH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5949 MOUNT EVERETT ROAD
Mailing Address - Street 2:
Mailing Address - City:HUBBARD
Mailing Address - State:OH
Mailing Address - Zip Code:44425
Mailing Address - Country:US
Mailing Address - Phone:330-568-1328
Mailing Address - Fax:
Practice Address - Street 1:1599 NORTH HERMITAGE RD
Practice Address - Street 2:
Practice Address - City:HERMITAGE
Practice Address - State:PA
Practice Address - Zip Code:16148
Practice Address - Country:US
Practice Address - Phone:724-962-7920
Practice Address - Fax:724-962-6029
Is Sole Proprietor?:No
Enumeration Date:2006-01-18
Last Update Date:2008-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT009580L225100000X
OHPT06468225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1983093OtherHIGHMARK GROUP
PA220033OtherHEALTH AMERICA/HEALTH ASSURANCE
PA417713OtherHIGHMARK
PA579COtherUPMC
PA0019349330002Medicaid
PA025221OtherMEDICARE GROUP
PA724159OtherHEALTH AMERICA/HEALTH ASSURANCE
PA104392OtherUPMC
PA118111OtherMEDICARE GROUP
PA548783OtherHIGHMARK GROUP
PA023575XCGMedicare PIN
PA023575M45Medicare PIN