Provider Demographics
NPI:1407272552
Name:AGGIO, LUISA (OTR/L)
Entity Type:Individual
Prefix:
First Name:LUISA
Middle Name:
Last Name:AGGIO
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:825 N 16TH ST APT 2
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19130-2214
Mailing Address - Country:US
Mailing Address - Phone:609-828-6623
Mailing Address - Fax:
Practice Address - Street 1:3001 LINCOLN DR W STE I
Practice Address - Street 2:
Practice Address - City:MARLTON
Practice Address - State:NJ
Practice Address - Zip Code:08053-1528
Practice Address - Country:US
Practice Address - Phone:856-396-3173
Practice Address - Fax:856-396-0060
Is Sole Proprietor?:No
Enumeration Date:2014-03-13
Last Update Date:2014-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ46TR00643400225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist