Provider Demographics
NPI:1548648108
Name:KELOKATES, SAMUEL (DPT)
Entity type:Individual
Prefix:DR
First Name:SAMUEL
Middle Name:
Last Name:KELOKATES
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2021 E DAUPHIN ST
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19125-1517
Mailing Address - Country:US
Mailing Address - Phone:267-459-3191
Mailing Address - Fax:
Practice Address - Street 1:2418 E YORK ST
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19125-3006
Practice Address - Country:US
Practice Address - Phone:267-459-3191
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-05-14
Last Update Date:2023-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist