Provider Demographics
NPI:1538155486
Name:LESCALLETTE, DEAN RICHARD (PT)
Entity type:Individual
Prefix:MR
First Name:DEAN
Middle Name:RICHARD
Last Name:LESCALLETTE
Suffix:
Gender:M
Credentials:PT
Other - Prefix:MR
Other - First Name:DEAN
Other - Middle Name:RICHARD
Other - Last Name:LESCALLETTE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PT
Mailing Address - Street 1:619 E MAIN ST
Mailing Address - Street 2:
Mailing Address - City:HUMMELSTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:17036-1839
Mailing Address - Country:US
Mailing Address - Phone:717-566-6000
Mailing Address - Fax:
Practice Address - Street 1:619 E MAIN ST
Practice Address - Street 2:
Practice Address - City:HUMMELSTOWN
Practice Address - State:PA
Practice Address - Zip Code:17036-1839
Practice Address - Country:US
Practice Address - Phone:717-566-6000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-09-26
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT-5108-L2251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAR06870Medicare UPIN
PA544042PQAMedicare PIN