Diana L Bergbauer
Physical Therapist - Pediatrics
209 Martins Ln
Media
, Pennsylvania 19063-5854
Diana L Bergbauer
Physical Therapist - Pediatrics
209 Martins Ln
Media
, Pennsylvania 19063-5854
(610) 653-5190
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About
Features
Specialties
- Physical Therapist - Pediatrics
Languages spoken
- English
Location
First Address
- Diana L Bergbauer
- 209 Martins Ln
- Media, PA
- Zip : 19063-5854
- Phone : (610) 653-5190
Second Address
- Diana L Bergbauer
- 209 Martins Ln
- Media, PA
- Zip : 19063-5854
- Phone : (610) 653-5190
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 2251P0200X | Physical Therapist - Pediatrics | PT002558E | PA |
National Provider Identifier
| NPI | 1063758969 |
|---|---|
| Provider Name | Diana L Bergbauer |
| First Address | Media, PA 19063-5854 |
| Second Address | Media, PA 19063-5854 |
| Gender | F |
| NPI Entity type | Individual |
| Is Sole Proprietor | Yes |
| Is Organization Subpart | N/A |
| Enumeration Date | 20/12/2012 |
| Last Update Date | 20/12/2012 |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.