Provider Demographics
NPI:1013915891
Name:WERKHEISER, KATRINA FASSL (PT)
Entity type:Individual
Prefix:
First Name:KATRINA
Middle Name:FASSL
Last Name:WERKHEISER
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 1:2775 SCHOENERSVILLE RD
Mailing Address - Street 2:
Mailing Address - City:BETHLEHEM
Mailing Address - State:PA
Mailing Address - Zip Code:18017-7307
Mailing Address - Country:US
Mailing Address - Phone:610-861-8080
Mailing Address - Fax:610-807-0366
Practice Address - Street 1:2775 SCHOENERSVILLE RD
Practice Address - Street 2:
Practice Address - City:BETHLEHEM
Practice Address - State:PA
Practice Address - Zip Code:18017-7307
Practice Address - Country:US
Practice Address - Phone:610-861-8080
Practice Address - Fax:610-807-0366
Is Sole Proprietor?:No
Enumeration Date:2005-07-14
Last Update Date:2008-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT013531L225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
0854356000OtherKEYSTONE HEALTH PLAN EAST
2560381OtherAETNA
PA01849369Medicaid
P00090399OtherRAILROAD MEDICARE
02208501OtherKEYSTONE HEALTH PLAN CENTRAL
P3176057OtherOXFORD HEALTH PLANS
2201253OtherUNITED HEALTHCARE
929198OtherHIGHMARK BLUE SHIELD
0854356000OtherINDEPENDENCE BLUE CROSS
328987OtherHEALTH AMERICAN/HEALTH ASSURANCE
PA01849369Medicaid