Provider Demographics
NPI:1932275310
Name:PRUSHINSKI, MELISSA KATHERINE (MSPT)
Entity Type:Individual
Prefix:MRS
First Name:MELISSA
Middle Name:KATHERINE
Last Name:PRUSHINSKI
Suffix:
Gender:F
Credentials:MSPT
Other - Prefix:MISS
Other - First Name:MELISSA
Other - Middle Name:KATHERINE
Other - Last Name:LAZARSKI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1086 ROUTE 315
Mailing Address - Street 2:PRO REHABILITATION SERVICES
Mailing Address - City:PLAINS
Mailing Address - State:PA
Mailing Address - Zip Code:18702
Mailing Address - Country:US
Mailing Address - Phone:570-823-7761
Mailing Address - Fax:570-822-8033
Practice Address - Street 1:1086 ROUTE 315
Practice Address - Street 2:
Practice Address - City:PLAINS
Practice Address - State:PA
Practice Address - Zip Code:18702
Practice Address - Country:US
Practice Address - Phone:570-823-7761
Practice Address - Fax:570-822-8033
Is Sole Proprietor?:No
Enumeration Date:2006-11-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT012718L225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
818036OtherFIRST PRIORITY
1555187OtherBLUE SHIELD
393538OtherHEALTH AMERICA ASSURANCE
393539OtherHEALTH AMERICA ASSURANCE
348556OtherHEALTH AMERICA ASSURANCE
810397OtherFIRST PRIORITY
818035OtherFIRST PRIORITY