Provider Demographics
NPI:1023812716
Name:SIEGEL, WILLIAM LEONARD (ATC)
Entity type:Individual
Prefix:
First Name:WILLIAM
Middle Name:LEONARD
Last Name:SIEGEL
Suffix:
Gender:M
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:316 E LAKE ST
Mailing Address - Street 2:
Mailing Address - City:CRANBERRY TOWNSHIP
Mailing Address - State:PA
Mailing Address - Zip Code:16066-5720
Mailing Address - Country:US
Mailing Address - Phone:724-954-5825
Mailing Address - Fax:
Practice Address - Street 1:316 E LAKE ST
Practice Address - Street 2:
Practice Address - City:CRANBERRY TOWNSHIP
Practice Address - State:PA
Practice Address - Zip Code:16066-5720
Practice Address - Country:US
Practice Address - Phone:724-954-5825
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-02
Last Update Date:2025-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PART001160A2255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer