Susan Jean Baka, C.P.T.A..
Individual provider Active NPI Physical Therapy Assistant · Brockway, PA
NPI 1700224425 · NPPES record last updated Jun 5, 2013
Key facts
- NPI
- 1700224425
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapy Assistant 225200000X
- License
- TE1000845 (PA)
- Practice address
- 433 Main St
Brockway, PA 15824-1337 - Phone
- (814) 265-8508
- Fax
- (814) 265-8158
- NPI assigned
- Jun 5, 2013
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| TE1000845 | PA | MD | Physical Therapy Assistant |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapy Assistant | 225200000X | TE1000845 | PA | Yes |
Addresses
Primary practice location
433 Main St
Brockway, PA 15824-1337
Mailing address
433 Main Street
Brockway, PA 15824
Phone (814) 265-8508
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1760421689 | Other | PA | NPI |
Other providers in Brockway, PA
All providers in Brockway, PA · Physical Therapy Assistant in Pennsylvania
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 5, 2013. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.