Active NPI
Brenda A Stachurski, DPT
- Physical Therapist
- Hazleton, PA
National Provider Identifier
1861690430
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PT016954
- Practice address
- 1000 W 27TH St
Hazleton, PA 18202-9604 - Phone
- (570) 454-8888
- NPI assigned
- Jul 5, 2007
- 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 | PT016954 | PA | Primary |
Addresses
Primary practice location
1000 W 27TH St
Hazleton, PA 18202-9604
Mailing address
12 Terrace Dr
Mountain Top, PA 18707-1815
Phone (570) 474-5190
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 |
|---|---|---|---|
| PT016954 | PA | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1183593600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1383609600000",
"number": "1861690430",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12 TERRACE DR",
"city": "MOUNTAIN TOP",
"state": "PA",
"postal_code": "187071815",
"telephone_number": "570-474-5190"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1000 W 27TH ST",
"city": "HAZLETON",
"state": "PA",
"postal_code": "182029604",
"telephone_number": "570-454-8888"
}
],
"practiceLocations": [],
"basic": {
"last_name": "STACHURSKI",
"first_name": "BRENDA",
"middle_name": "A",
"credential": "DPT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-07-05",
"last_updated": "2013-11-05",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "PA",
"license": "PT016954",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Hazleton, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 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.