Provider Demographics
NPI:1417469214
Name:MURMELLO, CAROL ANN (MPT)
Entity Type:Individual
Prefix:
First Name:CAROL
Middle Name:ANN
Last Name:MURMELLO
Suffix:
Gender:F
Credentials:MPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5220 SURREY CT
Mailing Address - Street 2:
Mailing Address - City:ALLENTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18104-9641
Mailing Address - Country:US
Mailing Address - Phone:610-657-5951
Mailing Address - Fax:
Practice Address - Street 1:5220 SURREY CT
Practice Address - Street 2:
Practice Address - City:ALLENTOWN
Practice Address - State:PA
Practice Address - Zip Code:18104-9641
Practice Address - Country:US
Practice Address - Phone:610-657-5951
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-11-02
Last Update Date:2017-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT006837-L208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation