Provider Demographics
NPI:1144519448
Name:CRUSH, GERADINE (PT)
Entity type:Individual
Prefix:
First Name:GERADINE
Middle Name:
Last Name:CRUSH
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:GERADINE
Other - Middle Name:
Other - Last Name:ACCORDINO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:918 YOUNGSTOWN WARREN RD
Mailing Address - Street 2:SUITE A
Mailing Address - City:NILES
Mailing Address - State:OH
Mailing Address - Zip Code:44446-4623
Mailing Address - Country:US
Mailing Address - Phone:330-505-1606
Mailing Address - Fax:330-505-1606
Practice Address - Street 1:918 YOUNGSTOWN WARREN RD
Practice Address - Street 2:SUITE A
Practice Address - City:NILES
Practice Address - State:OH
Practice Address - Zip Code:44446-4623
Practice Address - Country:US
Practice Address - Phone:330-505-1606
Practice Address - Fax:330-505-1606
Is Sole Proprietor?:No
Enumeration Date:2011-04-07
Last Update Date:2011-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPT 002535225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist