Provider Demographics
NPI:1639476823
Name:SCAVELLA, PINO JOSEPH (OTR/L)
Entity Type:Individual
Prefix:MR
First Name:PINO
Middle Name:JOSEPH
Last Name:SCAVELLA
Suffix:
Gender:M
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5510 MILLFAIR RD
Mailing Address - Street 2:
Mailing Address - City:FAIRVIEW
Mailing Address - State:PA
Mailing Address - Zip Code:16415-2228
Mailing Address - Country:US
Mailing Address - Phone:814-450-2822
Mailing Address - Fax:
Practice Address - Street 1:5510 MILLFAIR RD
Practice Address - Street 2:
Practice Address - City:FAIRVIEW
Practice Address - State:PA
Practice Address - Zip Code:16415-2228
Practice Address - Country:US
Practice Address - Phone:814-450-2822
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-02-24
Last Update Date:2022-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOC011743225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist