MEDICARE: MS. NANCY J FRITCH P.T.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist	PT012785L	PA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier Issuer
1	0444375000	OTHER	KEYSTONE PIN
2	7216024	OTHER	AETNA PPO PIN
3	1150586	OTHER	AETNA HMO PIN
4	0444375000	OTHER	PERSONAL CHOICE PIN
5	674942	OTHER	BS/BC PIN

General Provider Information

NPI Number	:	1598729543
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. NANCY J FRITCH P.T.

Provider Business Mailing Address
First Line	:	245 WARRIOR RD
Second Line	:
City	:	DREXEL HILL
State	:	PA
Zip	:	19026-5026
Country	:	US
Telephone Number	:	215-545-0941
Fax Number	:

Provider Business Practice Location Address
First Line	:	57 W EAGLE RD
Second Line	:	SUITE 1
City	:	HAVERTOWN
State	:	PA
Zip	:	19083-2234
Country	:	US
Telephone Number	:	610-789-9887
Fax Number	:	610-789-9883

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/14/2006
Last Update Date	:	02/27/2008

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