Provider Demographics
NPI:1881740108
Name:KANAGY, JOHN TIMOTHY (JOHN KANAGY, MSOTRL)
Entity type:Individual
Prefix:MR
First Name:JOHN
Middle Name:TIMOTHY
Last Name:KANAGY
Suffix:
Gender:M
Credentials:JOHN KANAGY, MSOTRL
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:402 ATKINS AVE
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:PA
Mailing Address - Zip Code:17603-4913
Mailing Address - Country:US
Mailing Address - Phone:717-207-0190
Mailing Address - Fax:
Practice Address - Street 1:2829 LITITZ PIKE
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:PA
Practice Address - Zip Code:17601-3321
Practice Address - Country:US
Practice Address - Phone:717-569-3211
Practice Address - Fax:717-569-1569
Is Sole Proprietor?:No
Enumeration Date:2007-01-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOC006452L225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist