Provider Demographics
NPI:1306289855
Name:CRUSH, IWALANI M (PT, DPT, PRPC, CSC)
Entity type:Individual
Prefix:DR
First Name:IWALANI
Middle Name:M
Last Name:CRUSH
Suffix:
Gender:F
Credentials:PT, DPT, PRPC, CSC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 MOORE CIR
Mailing Address - Street 2:
Mailing Address - City:MEDIA
Mailing Address - State:PA
Mailing Address - Zip Code:19063-4953
Mailing Address - Country:US
Mailing Address - Phone:808-561-2266
Mailing Address - Fax:
Practice Address - Street 1:1 MOORE CIR
Practice Address - Street 2:
Practice Address - City:MEDIA
Practice Address - State:PA
Practice Address - Zip Code:19063-4953
Practice Address - Country:US
Practice Address - Phone:808-561-2266
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-04-15
Last Update Date:2025-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT028288225100000X
PADAPT004698225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist