Provider Demographics
NPI:1588733836
Name:WAIBEL MAHARAJ, NANCY JEANNE (PT)
Entity type:Individual
Prefix:MRS
First Name:NANCY
Middle Name:JEANNE
Last Name:WAIBEL MAHARAJ
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 1:1105 18TH ST
Mailing Address - Street 2:
Mailing Address - City:ALTOONA
Mailing Address - State:PA
Mailing Address - Zip Code:16601-2421
Mailing Address - Country:US
Mailing Address - Phone:814-944-6535
Mailing Address - Fax:814-944-6545
Practice Address - Street 1:1105 18TH ST
Practice Address - Street 2:
Practice Address - City:ALTOONA
Practice Address - State:PA
Practice Address - Zip Code:16601-2421
Practice Address - Country:US
Practice Address - Phone:814-944-6535
Practice Address - Fax:814-944-6545
Is Sole Proprietor?:No
Enumeration Date:2006-11-08
Last Update Date:2008-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLPT20208OtherLICENSE#
PAPT013661LOtherLICENSE#