Provider Demographics
NPI:1609034826
Name:COOLEY, PAULETTE CITRO (BSPT)
Entity Type:Individual
Prefix:
First Name:PAULETTE
Middle Name:CITRO
Last Name:COOLEY
Suffix:
Gender:F
Credentials:BSPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:50 TERRACE RD
Mailing Address - Street 2:
Mailing Address - City:PLYMOUTH MEETING
Mailing Address - State:PA
Mailing Address - Zip Code:19462-2607
Mailing Address - Country:US
Mailing Address - Phone:610-279-5522
Mailing Address - Fax:
Practice Address - Street 1:50 TERRACE RD
Practice Address - Street 2:
Practice Address - City:PLYMOUTH MEETING
Practice Address - State:PA
Practice Address - Zip Code:19462-2607
Practice Address - Country:US
Practice Address - Phone:610-279-5522
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-05-23
Last Update Date:2008-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT010861L225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist