Provider Demographics
NPI:1750876850
Name:LEBIAK, ALEXANDER III (DPT)
Entity type:Individual
Prefix:
First Name:ALEXANDER
Middle Name:
Last Name:LEBIAK
Suffix:III
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1086 HIGHWAY 315 BLVD
Mailing Address - Street 2:
Mailing Address - City:PLAINS
Mailing Address - State:PA
Mailing Address - Zip Code:18702-7012
Mailing Address - Country:US
Mailing Address - Phone:570-823-7761
Mailing Address - Fax:
Practice Address - Street 1:4805 BIRNEY AVE
Practice Address - Street 2:
Practice Address - City:MOOSIC
Practice Address - State:PA
Practice Address - Zip Code:18507-1231
Practice Address - Country:US
Practice Address - Phone:570-774-4200
Practice Address - Fax:570-589-2196
Is Sole Proprietor?:No
Enumeration Date:2018-06-30
Last Update Date:2023-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT026715225100000X, 208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist