Provider Demographics
NPI:1861207730
Name:KANYARUSOKE, DIANA DELANY (PT, DPT)
Entity type:Individual
Prefix:
First Name:DIANA
Middle Name:DELANY
Last Name:KANYARUSOKE
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:DIANA
Other - Middle Name:DELANY
Other - Last Name:WATSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT, DPT
Mailing Address - Street 1:1033 COUNTRY CLUB RD
Mailing Address - Street 2:
Mailing Address - City:JEANNETTE
Mailing Address - State:PA
Mailing Address - Zip Code:15644-4721
Mailing Address - Country:US
Mailing Address - Phone:724-549-8071
Mailing Address - Fax:
Practice Address - Street 1:2526 MONROEVILLE BLVD STE 3
Practice Address - Street 2:
Practice Address - City:MONROEVILLE
Practice Address - State:PA
Practice Address - Zip Code:15146-2358
Practice Address - Country:US
Practice Address - Phone:412-457-8200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-02-10
Last Update Date:2025-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT030071225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist