Provider Demographics
NPI:1568716355
Name:POLLINO, SAMANTHA ANN (DPT)
Entity Type:Individual
Prefix:
First Name:SAMANTHA
Middle Name:ANN
Last Name:POLLINO
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9613 LINCOLN HWY
Mailing Address - Street 2:SUITE 107
Mailing Address - City:BEDFORD
Mailing Address - State:PA
Mailing Address - Zip Code:15522-3748
Mailing Address - Country:US
Mailing Address - Phone:814-623-1042
Mailing Address - Fax:814-623-1044
Practice Address - Street 1:9613 LINCOLN HWY
Practice Address - Street 2:SUITE 107
Practice Address - City:BEDFORD
Practice Address - State:PA
Practice Address - Zip Code:15522-3748
Practice Address - Country:US
Practice Address - Phone:814-623-1042
Practice Address - Fax:814-623-1044
Is Sole Proprietor?:No
Enumeration Date:2012-11-01
Last Update Date:2012-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT022447225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist