Provider Demographics
NPI:1053734087
Name:MANANCERO, FILISHA LUSTFIELD (PT, DPT)
Entity type:Individual
Prefix:MS
First Name:FILISHA
Middle Name:LUSTFIELD
Last Name:MANANCERO
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:803 RYDAL RD
Mailing Address - Street 2:
Mailing Address - City:JENKINTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:19046-2324
Mailing Address - Country:US
Mailing Address - Phone:605-212-1175
Mailing Address - Fax:
Practice Address - Street 1:803 RYDAL RD
Practice Address - Street 2:
Practice Address - City:JENKINTOWN
Practice Address - State:PA
Practice Address - Zip Code:19046-2324
Practice Address - Country:US
Practice Address - Phone:215-543-4092
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-01-27
Last Update Date:2025-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT030811225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist