Basic Information
Provider Information
NPI: 1265916076
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: KREFT
FirstName: ANTHONY
MiddleName: D
NamePrefix:  
NameSuffix:  
Credential: DPT
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
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OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 3809 W CHESTER PIKE STE 150
Address2:  
City: NEWTOWN SQUARE
State: PA
PostalCode: 190730259
CountryCode: US
TelephoneNumber: 6103595671
FaxNumber: 6103591519
Practice Location
Address1: 1561 MEDICAL DR
Address2:  
City: POTTSTOWN
State: PA
PostalCode: 19464
CountryCode: US
TelephoneNumber: 4849416734
FaxNumber: 6103265567
Other Information
ProviderEnumerationDate: 09/18/2018
LastUpdateDate: 03/14/2019
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
225100000XPT027126PAY Respiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist 

No ID Information.


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