Provider Demographics
NPI:1619493715
Name:RAFFA, SALVATORE PAUL (ATC)
Entity Type:Individual
Prefix:
First Name:SALVATORE
Middle Name:PAUL
Last Name:RAFFA
Suffix:
Gender:M
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2310 BIRCH CT
Mailing Address - Street 2:
Mailing Address - City:WARRINGTON
Mailing Address - State:PA
Mailing Address - Zip Code:18976-1592
Mailing Address - Country:US
Mailing Address - Phone:267-474-7279
Mailing Address - Fax:
Practice Address - Street 1:2310 BIRCH CT
Practice Address - Street 2:
Practice Address - City:WARRINGTON
Practice Address - State:PA
Practice Address - Zip Code:18976-1592
Practice Address - Country:US
Practice Address - Phone:267-474-7279
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-08-21
Last Update Date:2017-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PART0035682255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer