Provider Demographics
NPI:1528172707
Name:MILDIN, INC
Entity type:Organization
Organization Name:MILDIN, INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PHYSICAL THERAPIST, PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:DONALD
Authorized Official - Last Name:CARDIN
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:717-245-0400
Mailing Address - Street 1:290 E POMFRET ST
Mailing Address - Street 2:SUITE 1
Mailing Address - City:CARLISLE
Mailing Address - State:PA
Mailing Address - Zip Code:17013-2579
Mailing Address - Country:US
Mailing Address - Phone:717-245-0400
Mailing Address - Fax:717-243-5688
Practice Address - Street 1:290 E POMFRET ST
Practice Address - Street 2:SUITE 1
Practice Address - City:CARLISLE
Practice Address - State:PA
Practice Address - Zip Code:17013-2579
Practice Address - Country:US
Practice Address - Phone:717-245-0400
Practice Address - Fax:717-243-5688
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-18
Last Update Date:2010-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA335E00000X
PAPT013395L225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
No335E00000XSuppliersProsthetic/Orthotic SupplierGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PADF0847OtherRAIL ROAD MEDICARE
PADF0847OtherRAIL ROAD MEDICARE
PA098237Medicare PIN