Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Mr. Keith Martin Liccardi, MPT

Individual provider Physical Therapist · NPI 1295040731

Mr. Keith Martin Liccardi, MPT is a Physical Therapist in Private Practice in Fairview, Pennsylvania. Qualified in 2001, 25 years ago. Practices as a sole proprietor. Licensed in Pennsylvania.

Years since qualifying
25
Licensed in
PA
In the registry since
2010
What do these letters mean?
MPT — Master of Physical Therapy
The master's-level physical therapy degree awarded before the DPT became standard.

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Practice location Address checks out

890 Greener Pl
Fairview, PA 16415-1567
Phone: (814) 474-5521
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physical Therapist (primary) Taxonomy 225100000X · Licence PT015537 (PA)

Record details

NPI number1295040731
Entity typeIndividual (Type 1)
GenderMale
Credentials MPT
Sole proprietorYes
NPI enumeratedAugust 9, 2010
Last updated in NPPESAugust 9, 2010

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICAL THERAPIST IN PRIVATE PRACTICE
Medical schoolOTHER
Graduated 2001 (25 years in practice)
Accepts Medicare assignment Not indicated

Other providers in Fairview