Provider Demographics
NPI:1730223942
Name:NADLER, CAROL L (PT)
Entity type:Individual
Prefix:MS
First Name:CAROL
Middle Name:L
Last Name:NADLER
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 1:160 N MCKEAN ST
Mailing Address - Street 2:STE 2
Mailing Address - City:KITTANNING
Mailing Address - State:PA
Mailing Address - Zip Code:16201-1570
Mailing Address - Country:US
Mailing Address - Phone:724-548-4438
Mailing Address - Fax:724-548-4438
Practice Address - Street 1:160 N MCKEAN ST
Practice Address - Street 2:STE 2
Practice Address - City:KITTANNING
Practice Address - State:PA
Practice Address - Zip Code:16201-1570
Practice Address - Country:US
Practice Address - Phone:724-548-4438
Practice Address - Fax:724-548-4438
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-19
Last Update Date:2016-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT000321E225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA11430947OtherAETNA
PAPT000321-EOtherLICENSE
PA123677000OtherFEDERAL WORKERS COMP #
PA1517857OtherUMWA #
PA1594985Medicaid
PA592975OtherBLUE SHIELD INDIVIDUAL #
PANA521491OtherBLUE SHIELD GROUP #
PA650007860Medicare ID - Type UnspecifiedR R MEDICARE
PA1594985Medicaid