Provider Demographics
NPI:1639624521
Name:CORDARO, ALLIE (PT, DPT)
Entity Type:Individual
Prefix:
First Name:ALLIE
Middle Name:
Last Name:CORDARO
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:ALLIE
Other - Middle Name:
Other - Last Name:DONATO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT, DPT
Mailing Address - Street 1:707 SHIRLEY LN
Mailing Address - Street 2:
Mailing Address - City:DUNMORE
Mailing Address - State:PA
Mailing Address - Zip Code:18512-2117
Mailing Address - Country:US
Mailing Address - Phone:570-604-1337
Mailing Address - Fax:
Practice Address - Street 1:707 SHIRLEY LN
Practice Address - Street 2:
Practice Address - City:DUNMORE
Practice Address - State:PA
Practice Address - Zip Code:18512-2117
Practice Address - Country:US
Practice Address - Phone:570-604-1337
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-08-20
Last Update Date:2022-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2305210143261QP2000X
PAPT025187261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy