Provider Demographics
NPI:1275090102
Name:CERALDI, JANET D
Entity Type:Individual
Prefix:
First Name:JANET
Middle Name:D
Last Name:CERALDI
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 1:1134 SOUTH ST
Mailing Address - Street 2:
Mailing Address - City:CORNELIUS
Mailing Address - State:NC
Mailing Address - Zip Code:28031-8164
Mailing Address - Country:US
Mailing Address - Phone:704-907-9314
Mailing Address - Fax:
Practice Address - Street 1:19530 MT ZION PKWY
Practice Address - Street 2:
Practice Address - City:CORNELIUS
Practice Address - State:NC
Practice Address - Zip Code:28031-8398
Practice Address - Country:US
Practice Address - Phone:704-997-2970
Practice Address - Fax:704-997-2971
Is Sole Proprietor?:Yes
Enumeration Date:2019-02-27
Last Update Date:2019-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC0546225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist