Provider Demographics
NPI:1548963200
Name:INSTASI, ALISHA (PTA)
Entity type:Individual
Prefix:
First Name:ALISHA
Middle Name:
Last Name:INSTASI
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:ALISHA
Other - Middle Name:
Other - Last Name:PEDERGNANA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:900 DERBYSHIRE AVE
Mailing Address - Street 2:
Mailing Address - City:MECHANICSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17055-5703
Mailing Address - Country:US
Mailing Address - Phone:717-514-2649
Mailing Address - Fax:
Practice Address - Street 1:1700 MARKET ST
Practice Address - Street 2:
Practice Address - City:CAMP HILL
Practice Address - State:PA
Practice Address - Zip Code:17011-4817
Practice Address - Country:US
Practice Address - Phone:717-737-8551
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-03-22
Last Update Date:2023-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PATEI1001360225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant