Provider Demographics
NPI:1174051304
Name:DEPAOLO, MONICA
Entity type:Individual
Prefix:
First Name:MONICA
Middle Name:
Last Name:DEPAOLO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2651 SUMMIT AVE
Mailing Address - Street 2:
Mailing Address - City:BROOMALL
Mailing Address - State:PA
Mailing Address - Zip Code:19008-1922
Mailing Address - Country:US
Mailing Address - Phone:610-405-7428
Mailing Address - Fax:
Practice Address - Street 1:2651 SUMMIT AVE
Practice Address - Street 2:
Practice Address - City:BROOMALL
Practice Address - State:PA
Practice Address - Zip Code:19008-1922
Practice Address - Country:US
Practice Address - Phone:610-405-7428
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-06-01
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Single Specialty