Provider Demographics
NPI:1083452296
Name:SORRENTINO, HALEY (DPT)
Entity type:Individual
Prefix:
First Name:HALEY
Middle Name:
Last Name:SORRENTINO
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:HALEY
Other - Middle Name:
Other - Last Name:GALLOWAY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DPT
Mailing Address - Street 1:241 HALLER RD
Mailing Address - Street 2:
Mailing Address - City:RIDLEY PARK
Mailing Address - State:PA
Mailing Address - Zip Code:19078-1320
Mailing Address - Country:US
Mailing Address - Phone:215-796-3825
Mailing Address - Fax:
Practice Address - Street 1:100 WALLACE AVE
Practice Address - Street 2:
Practice Address - City:DOWNINGTOWN
Practice Address - State:PA
Practice Address - Zip Code:19335-2641
Practice Address - Country:US
Practice Address - Phone:484-224-5600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-07-20
Last Update Date:2024-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT032516225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist