Provider Demographics
NPI:1215386990
Name:CAVALLO-CAMPISI, PILAR
Entity Type:Individual
Prefix:
First Name:PILAR
Middle Name:
Last Name:CAVALLO-CAMPISI
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 1:445 S DELAWARE DR
Mailing Address - Street 2:
Mailing Address - City:EASTON
Mailing Address - State:PA
Mailing Address - Zip Code:18042-9423
Mailing Address - Country:US
Mailing Address - Phone:610-515-9832
Mailing Address - Fax:
Practice Address - Street 1:445 S DELAWARE DR
Practice Address - Street 2:
Practice Address - City:EASTON
Practice Address - State:PA
Practice Address - Zip Code:18042-9423
Practice Address - Country:US
Practice Address - Phone:610-515-9832
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-06-03
Last Update Date:2016-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMSG003559225700000X
225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist