Individual
MRS. ANGELA ROSEMARIE TATE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT, PHD, CERT MDT
Contact information
Practice address
1003 EASTON RD, 105 CHATEAU, WILLOW GROVE, PA 19090-2027
(215) 659-7759
(215) 659-6658
Mailing address
1003 EASTON RD, 105 CHATEAU, WILLOW GROVE, PA 19090-2027
(215) 659-7759
(215) 659-6658
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT006102L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000644553
BLUE CROSS BLUE SHIELD
PA
05
—
1011976290001
—
PA
01
—
2101185
AETNA
PA
01
—
30022508
KEYSTONE MERCY
PA
Enumeration date
10/31/2005
Last updated
02/10/2015
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