Mitzie Tanjutco Espinosa, PT
Individual provider Active NPI Physical Therapist · Schuylkill Haven, PA
NPI 1922126325 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1922126325
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapist 225100000X
- License
- PT018362 (PA)
- Practice address
- 401 University Dr
Therapy Dept.
Schuylkill Haven, PA 17972-2211 - Phone
- (570) 385-0331
- NPI assigned
- Mar 26, 2007
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|
| PT018362 | PA | MD | Physical Therapist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | PT018362 | PA | Yes |
Addresses
Primary practice location
401 University Dr
Therapy Dept.
Schuylkill Haven, PA 17972-2211
Mailing address
127 Forget Me Not LN
Apt. 2C
Schuylkill Haven, PA 17972-1035
Phone (956) 763-0504
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| GEA3036016200 | Other | PA | BLUE CROSS PPO PROGRAM |
Other providers in Schuylkill Haven, PA
- Lauren Dove
- Dr. Donald L. Borger
- Darren Eric Dreher
- Edward J Gaydos DPM PC
- Ella Margaret Eshleman
- Krista J Essler
- Jeffrey Scott Faust
- Elizabeth Santos Fisher
- Francis G. a. Solga,DDS, PC
- Carroll S. Freestone
All providers in Schuylkill Haven, PA · Physical Therapist in Pennsylvania
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. 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.