Provider Demographics
NPI:1487616249
Name:TOMPKINS-SEPESKY, KRISTEN M (MPT)
Entity type:Individual
Prefix:
First Name:KRISTEN
Middle Name:M
Last Name:TOMPKINS-SEPESKY
Suffix:
Gender:F
Credentials:MPT
Other - Prefix:
Other - First Name:KRISTEN
Other - Middle Name:M
Other - Last Name:TOMPKINS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MPT
Mailing Address - Street 1:438 PELLIS RD
Mailing Address - Street 2:SUITE 101
Mailing Address - City:GREENSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:15601-7900
Mailing Address - Country:US
Mailing Address - Phone:724-850-7587
Mailing Address - Fax:724-850-9909
Practice Address - Street 1:520 PELLIS RD
Practice Address - Street 2:SUITE 1000
Practice Address - City:GREENSBURG
Practice Address - State:PA
Practice Address - Zip Code:15601-4777
Practice Address - Country:US
Practice Address - Phone:724-838-1008
Practice Address - Fax:724-832-1690
Is Sole Proprietor?:No
Enumeration Date:2006-04-05
Last Update Date:2011-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT008317L225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0016000710001Medicaid
PA004881Medicare ID - Type Unspecified
PAS72296Medicare UPIN