Mandy L Gwin

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

TEI001465 Issued in PA

Practice address

419 Waterford St
Edinboro, PA 16412-5517

Phone

(814) 734-5021

Fax

(814) 734-1433

NPI assigned

Dec 3, 2015

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other names 1

• Mandy L Wolfgang Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1449100800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1449100800000",
    "number": "1194190025",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1100 SHAWNEE ROAD",
            "city": "LIMA",
            "state": "OH",
            "postal_code": "45805",
            "telephone_number": "419-999-2030",
            "fax_number": "419-991-0909"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "419 WATERFORD ST",
            "city": "EDINBORO",
            "state": "PA",
            "postal_code": "164125517",
            "telephone_number": "814-734-5021",
            "fax_number": "814-734-1433"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GWIN",
        "first_name": "MANDY",
        "middle_name": "L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-12-03",
        "last_updated": "2015-12-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "PA",
            "license": "TEI001465",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MANDY",
            "last_name": "WOLFGANG",
            "middle_name": "L",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Katelyn Goodenow, LPC
• Craig Gourley, MSW , LSW
• Greater Erie Community Action Committee (GECAC D&A Services)
• Stacy Jo Green, CRNP
• Steven J Grygier, D.C.
• Rachel Jean Hamm Van Valkenberg
• Mimi C Haney, OTR/L
• Gary Robert Hanna, ATC
• Jennifer Hardy, PHD
• Sara Hastings, LPC

• Physical Therapy Assistant in Edinboro, PA
• Providers in Edinboro, PA by specialty
• Physical Therapy Assistant in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.