Provider Demographics
NPI:1912073495
Name:LAMANNA, BETH (MS PT)
Entity type:Individual
Prefix:MRS
First Name:BETH
Middle Name:
Last Name:LAMANNA
Suffix:
Gender:F
Credentials:MS PT
Other - Prefix:MISS
Other - First Name:BETH
Other - Middle Name:
Other - Last Name:KOSTICK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1324 N CHURCH ST
Mailing Address - Street 2:STE 4
Mailing Address - City:HAZLE TOWNSHIP
Mailing Address - State:PA
Mailing Address - Zip Code:18202-9307
Mailing Address - Country:US
Mailing Address - Phone:570-501-1808
Mailing Address - Fax:855-635-6308
Practice Address - Street 1:685 CAREY AVE
Practice Address - Street 2:
Practice Address - City:HANOVER TOWNSHIP
Practice Address - State:PA
Practice Address - Zip Code:18706-5489
Practice Address - Country:US
Practice Address - Phone:570-829-0539
Practice Address - Fax:570-829-4036
Is Sole Proprietor?:No
Enumeration Date:2006-11-28
Last Update Date:2017-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT015811225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
388457OtherHEALTH AMERICA ASSURANCE
393572OtherHEALTH AMERICA ASSURANCE
817818OtherFIRST PRIORITY
818051OtherFIRST PRIORITY
393573OtherHEALTH AMERICA ASSURANCE
815880OtherFIRST PRIORITY