Provider Demographics
NPI:1730266701
Name:MURGITROYDE, KERRY ANNE (OTRL)
Entity type:Individual
Prefix:MRS
First Name:KERRY
Middle Name:ANNE
Last Name:MURGITROYDE
Suffix:
Gender:F
Credentials:OTRL
Other - Prefix:MS
Other - First Name:KERRY
Other - Middle Name:ANNE
Other - Last Name:GLEESON
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:1511 CENTRE TURNPIKE
Mailing Address - Street 2:STEPPING STONES REHABILITATION INC PC
Mailing Address - City:ORWIGSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17961
Mailing Address - Country:US
Mailing Address - Phone:570-366-3722
Mailing Address - Fax:570-366-3781
Practice Address - Street 1:1511 CENTRE TURNPIKE
Practice Address - Street 2:STEPPING STONES REHABILITATION INC PC
Practice Address - City:ORWIGSBURG
Practice Address - State:PA
Practice Address - Zip Code:17961
Practice Address - Country:US
Practice Address - Phone:570-366-3722
Practice Address - Fax:570-366-3781
Is Sole Proprietor?:No
Enumeration Date:2006-11-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOC010146225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1017096290001Medicaid
PA1892625OtherBLUE SHIELD PA