Taxonomy Codes
The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:
| No. |
Taxonomy Code |
Taxonomy Clasification |
Taxonomy Specialization |
License Number |
License State |
Primary |
| 1 | 225100000X | Physical Therapist | | PT017535 | PENNSYLVANIA | Yes |
Other Identifiers
The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.
| No. |
Other Provider Identifier |
Other Provider Identifier Type |
Other Provider Identifier State |
Other Provider Identifier Issuer |
| 1 | 4378613 | OTHER | | DENNIS DOUGHERTY PPO# |
| 2 | 4572840 | OTHER | | NIKOL TEWS PPO# |
| 3 | 7191743 | OTHER | | BETH VOTRAL PPO# |
| 4 | 7454667 | OTHER | | CHRIS DUE PPO# |
| 5 | 3311522 | OTHER | | HMO REHAB PARTNERS |
| 6 | 7293473 | OTHER | | PPO NEW VALLEY |
| 7 | 50056203 | OTHER | PENNSYLVANIA | CAPITAL |
| 8 | 7449501 | OTHER | | PPO REHAB PARTNERS |
| 9 | 3995218 | OTHER | | RETT HOLMES HMO# |
| 10 | 3312931 | OTHER | | HMO NEW VALLEY CAPITATION |
| 11 | 3336072 | OTHER | | ANDREW PERICH HMO# |
| 12 | DVI765414 | OTHER | PENNSYLVANIA | HIGHMARK |
| 13 | 3345114 | OTHER | | DENNIS DOUGHERTY HMO# |
| 14 | 7524519 | OTHER | | ANDREW PERICH PPO # |
| 15 | 1065392 | OTHER | | CHRIS DUE HMO# |
| 16 | 1059204 | OTHER | | BETH VOTRAL HMO# |
| 17 | 3312272 | OTHER | | NIKOL TEWS HMO# |
| 18 | 4378121 | OTHER | | SUSAN REAGAN PPO# |
| 19 | 7228707 | OTHER | | RETT HOLMES PPO# |
