Active NPI
Melissa Pavlick, MSPT
- Physical Therapist
- Hazleton, PA
National Provider Identifier
1710225552
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PT019179
- Practice address
- 1711 E Broad St
Hazleton, PA 18201-5691 - Phone
- (570) 453-5133
- NPI assigned
- Jan 29, 2013
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | PT019179 | PA | Primary |
Addresses
Primary practice location
1711 E Broad St
Hazleton, PA 18201-5691
Mailing address
1711 E Broad St
Hazleton, PA 18201-5691
Phone (570) 453-5133
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PT019179 | PA | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1359417600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1359417600000",
"number": "1710225552",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1711 E BROAD ST",
"city": "HAZLETON",
"state": "PA",
"postal_code": "182015691",
"telephone_number": "570-453-5133"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1711 E BROAD ST",
"city": "HAZLETON",
"state": "PA",
"postal_code": "182015691",
"telephone_number": "570-453-5133"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PAVLICK",
"first_name": "MELISSA",
"credential": "MSPT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2013-01-29",
"last_updated": "2013-01-29",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "PA",
"license": "PT019179",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Hazleton, PA
- Minaben Dilipkumar Patel, MD
- Pathway to Everyday Life Human Services Inc
- Pathway to Recovery Counseling & Educational Services
- Donald A Patten, M.D.
- Pavilion at St. Luke Village Facility Operations, LLC
- Russell Pearson
- Megan Rileigh Peifer
- Dorothy A Perillo, PA-C
- Christina Perry
- Shelby Linn Petro, LSW
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.