Basic Information
| Provider Information | |||||||||
| NPI: | 1780980581 | ||||||||
| EntityType: | 1 | ||||||||
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| LastName: | MEKETA | ||||||||
| FirstName: | ANNE | ||||||||
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| Mailing Information | |||||||||
| Address1: | 868 UNION ST | ||||||||
| Address2: | |||||||||
| City: | MILLERSBURG | ||||||||
| State: | PA | ||||||||
| PostalCode: | 170611476 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7173296932 | ||||||||
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| Practice Location | |||||||||
| Address1: | 500 UNIVERSITY DR, MC A410 | ||||||||
| Address2: | |||||||||
| City: | HERSHEY | ||||||||
| State: | PA | ||||||||
| PostalCode: | 17033 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8002431455 | ||||||||
| FaxNumber: | 7175317269 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/27/2011 | ||||||||
| LastUpdateDate: | 01/27/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 01/26/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225200000X | TE008340 | PA | N | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapy Assistant | 225200000X | TEI004080 | PA | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapy Assistant |
No ID Information.