Provider Demographics
NPI:1598384869
Name:ACCORDINO, NICOLE A
Entity Type:Individual
Prefix:
First Name:NICOLE
Middle Name:A
Last Name:ACCORDINO
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 1:95 HILLTOP BLVD
Mailing Address - Street 2:
Mailing Address - City:CANFIELD
Mailing Address - State:OH
Mailing Address - Zip Code:44406-1219
Mailing Address - Country:US
Mailing Address - Phone:330-519-3394
Mailing Address - Fax:
Practice Address - Street 1:2380 HIGHLAND RD
Practice Address - Street 2:
Practice Address - City:HERMITAGE
Practice Address - State:PA
Practice Address - Zip Code:16148-2819
Practice Address - Country:US
Practice Address - Phone:724-983-3960
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-04-15
Last Update Date:2020-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA0123682251P0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatrics