Healthcare Provider Details

I. General information

NPI: 1740243583
Provider Name (Legal Business Name): ANN ELIZABETH REPPERMUND PT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/11/2006
Last Update Date: 03/18/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1010 DELAFIELD RD 132Y-U
PITTSBURGH PA
15215-1802
US

IV. Provider business mailing address

4810 WOODLAKE DR
ALLISON PARK PA
15101-1020
US

V. Phone/Fax

Practice location:
  • Phone: 412-822-2111
  • Fax:
Mailing address:
  • Phone: 724-444-5359
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT017200
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: