Healthcare Provider Details

I. General information

NPI: 1083519003
Provider Name (Legal Business Name): BETHANY BURTYK
Entity Type: Individual
Gender:
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/09/2026
Last Update Date: 10/09/2026
Certification Date: 10/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

491 E 8TH AVE
HOMESTEAD PA
15120-1901
US

IV. Provider business mailing address

2400 ARDMORE BLVD
PITTSBURGH PA
15221-5299
US

V. Phone/Fax

Practice location:
  • Phone: 412-436-1320
  • Fax:
Mailing address:
  • Phone: 412-436-1320
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225200000X
TaxonomyPhysical Therapy Assistant
License NumberTEI005583
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: