Provider Demographics
NPI:1447261680
Name:SAPORETTI, KATHERINE A (PT)
Entity type:Individual
Prefix:MISS
First Name:KATHERINE
Middle Name:A
Last Name:SAPORETTI
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1098 W BALTIMORE PIKE
Mailing Address - Street 2:LOBBY LEVEL
Mailing Address - City:MEDIA
Mailing Address - State:PA
Mailing Address - Zip Code:19063-5139
Mailing Address - Country:US
Mailing Address - Phone:610-891-3030
Mailing Address - Fax:610-891-3035
Practice Address - Street 1:1098 W BALTIMORE PIKE
Practice Address - Street 2:LOBBY LEVEL
Practice Address - City:MEDIA
Practice Address - State:PA
Practice Address - Zip Code:19063-5139
Practice Address - Country:US
Practice Address - Phone:610-891-3030
Practice Address - Fax:610-891-3035
Is Sole Proprietor?:No
Enumeration Date:2006-08-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT016813225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PASA1679781OtherPABS
PA2353699000OtherKEYSTONE