Provider Demographics
NPI:1578662318
Name:SIFTAR, MARTINA M (MSPT)
Entity type:Individual
Prefix:
First Name:MARTINA
Middle Name:M
Last Name:SIFTAR
Suffix:
Gender:F
Credentials:MSPT
Other - Prefix:
Other - First Name:MARTINA
Other - Middle Name:
Other - Last Name:KAMON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2100 MACK BLVD FL 4
Mailing Address - Street 2:
Mailing Address - City:ALLENTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18103-5622
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:4720 BATH PIKE FL 1
Practice Address - Street 2:
Practice Address - City:BETHLEHEM
Practice Address - State:PA
Practice Address - Zip Code:18017-9013
Practice Address - Country:US
Practice Address - Phone:484-862-3001
Practice Address - Fax:484-862-3013
Is Sole Proprietor?:No
Enumeration Date:2006-09-21
Last Update Date:2024-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT259072251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAWPT25907CMedicare ID - Type UnspecifiedMEDICARE NUMBER