Basic Information
Provider Information
NPI: 1235435694
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: FELEGE
FirstName: CARALYNN
MiddleName: ANNE
NamePrefix:  
NameSuffix:  
Credential: PT, DPT
OtherOrganizationName:  
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Mailing Information
Address1: 5300 DERRY ST
Address2: 2ND FLOOR
City: HARRISBURG
State: PA
PostalCode: 171113576
CountryCode: US
TelephoneNumber: 7178392110
FaxNumber: 7175651934
Practice Location
Address1: 2125 NOLL DR
Address2: SUITE 100
City: LANCASTER
State: PA
PostalCode: 176037606
CountryCode: US
TelephoneNumber: 7173919920
FaxNumber: 7173919925
Other Information
ProviderEnumerationDate: 02/02/2011
LastUpdateDate: 03/08/2016
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
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AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
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AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
225100000X1202840TXN Respiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist 
225100000XPT019490PAY Respiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist 

No ID Information.


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