Healthcare Provider Details

I. General information

NPI: 1710176581
Provider Name (Legal Business Name): TRACY A ALMEKINDER PT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: TRACY A GRIEBOSKI PT

II. Dates (important events)

Enumeration Date: 10/17/2007
Last Update Date: 08/19/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2010 ADAMS AVE
SCRANTON PA
18509-1599
US

IV. Provider business mailing address

2010 ADAMS AVE
SCRANTON PA
18509-1599
US

V. Phone/Fax

Practice location:
  • Phone: 570-963-1278
  • Fax: 570-963-1292
Mailing address:
  • Phone: 570-963-1278
  • Fax: 570-963-1292

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT019004
License Number StatePA

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

# 1
Identifier1020031110001
Identifier TypeMEDICAID
Identifier StatePA
Identifier Issuer

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: