Basic Information
| Provider Information | |||||||||
| NPI: | 1841255189 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | SCHUCK | ||||||||
| FirstName: | BRIAN | ||||||||
| MiddleName: | P. | ||||||||
| NamePrefix: | MR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | P.T. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2300 PLEASANT VALLEY RD | ||||||||
| Address2: | |||||||||
| City: | YORK | ||||||||
| State: | PA | ||||||||
| PostalCode: | 174029627 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7177573537 | ||||||||
| FaxNumber: | 7177189701 | ||||||||
| Practice Location | |||||||||
| Address1: | 1010 EICHELBERGER ST | ||||||||
| Address2: | SUITE 9 | ||||||||
| City: | HANOVER | ||||||||
| State: | PA | ||||||||
| PostalCode: | 173311374 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7177573537 | ||||||||
| FaxNumber: | 7177189701 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/19/2006 | ||||||||
| LastUpdateDate: | 06/07/2016 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225100000X | PT016009 | PA | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist |
ID Information
| ID | Type | State | Issuer | Description | 50007909 | 01 | PA | CAPITAL BLUE CROSS | OTHER | 2103044 | 01 | PA | MAMSI | OTHER | 3051878 | 01 | PA | AETNA | OTHER | 1357893 | 01 | PA | HIGHMARK BLUE SHIELD | OTHER | 61932401 | 01 | MD | CAREFIRST BLUE SHIELD | OTHER | 0019371760001 | 05 | PA | MEDICAID |