Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251N0400X | Physical Therapist - Neurology | PT010336L | PA |
NPI | 1225109812 |
---|---|
Provider Name | Mr. Michael Paul Bacasa |
First Address | Pittsburgh, PA 15217-1442 |
Second Address | Pittsburgh, PA 15217-1660 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/11/2006 |
Last Update Date | 08/07/2007 |