Individual
HERNANI PANTINOPLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
HC 1 BOX 110, ROUTE209, BRODHEADSVILLE, PA 18322-9532
(570) 992-4400
(570) 992-5262
Mailing address
223 BLUE MOUNTAIN LK, EAST STROUDSBURG, PA 18301-8691
(201) 281-3619
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT011887L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1544361
BLUE SHIELD
PA
01
—
3344354
AETNA
PA
01
—
50031258
CAPITAL BLUE CROSS
PA
01
—
817259
FIRST PRIORITY
PA
Enumeration date
11/18/2005
Last updated
07/08/2007
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