Provider Demographics
NPI:1982605150
Name:DINGES, TROY S (PT)
Entity type:Individual
Prefix:
First Name:TROY
Middle Name:S
Last Name:DINGES
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:685 ISLAND RD
Mailing Address - Street 2:
Mailing Address - City:LOCK HAVEN
Mailing Address - State:PA
Mailing Address - Zip Code:17745-8844
Mailing Address - Country:US
Mailing Address - Phone:570-748-2678
Mailing Address - Fax:570-748-4015
Practice Address - Street 1:685 ISLAND RD
Practice Address - Street 2:
Practice Address - City:LOCK HAVEN
Practice Address - State:PA
Practice Address - Zip Code:17745-8844
Practice Address - Country:US
Practice Address - Phone:570-748-2678
Practice Address - Fax:570-748-4015
Is Sole Proprietor?:No
Enumeration Date:2005-08-10
Last Update Date:2010-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT007705L174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA140514OtherHEALTH AMERICA
PA927263OtherBC/BS-IND.
PA001874933Medicaid
PA140514OtherFIRST PRIORITY
PA001874933Medicaid