Basic Information
Provider Information
NPI: 1477766368
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: RIPANI
FirstName: AMBER
MiddleName: LYNN
NamePrefix:  
NameSuffix:  
Credential: PT
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName: WATERS
OtherFirstName: AMBER
OtherMiddleName: LYNN
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential: PT
OtherLastNameType: 1
Mailing Information
Address1: 493 WESTCHESTER DR
Address2:  
City: IRWIN
State: PA
PostalCode: 156422677
CountryCode: US
TelephoneNumber:  
FaxNumber:  
Practice Location
Address1: 200 COLLEGE DRIVE
Address2: SUITE 100
City: LEMONT FURNACE
State: PA
PostalCode: 15456
CountryCode: US
TelephoneNumber: 7244396061
FaxNumber: 7244396062
Other Information
ProviderEnumerationDate: 05/07/2007
LastUpdateDate: 07/08/2007
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
225100000XPT011242LPAY Respiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist 

No ID Information.


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