Basic Information
Provider Information
NPI: 1861458143
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: STAIGER
FirstName: DENISE
MiddleName: M
NamePrefix:  
NameSuffix:  
Credential: MSPT
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 5300 DERRY ST
Address2: 2ND FLOOR
City: HARRISBURG
State: PA
PostalCode: 171113576
CountryCode: US
TelephoneNumber: 7178392110
FaxNumber: 7175651934
Practice Location
Address1: 100 WHEATFIELD DR
Address2:  
City: MILFORD
State: PA
PostalCode: 183377673
CountryCode: US
TelephoneNumber: 5702965911
FaxNumber: 5702965931
Other Information
ProviderEnumerationDate: 04/25/2006
LastUpdateDate: 05/17/2016
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
225100000XPT017297PAY Respiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist 
225100000X40QA00496800NJN Respiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist 

No ID Information.


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