Provider Demographics
NPI:1649390113
Name:RONCOLATO, MARGARET MARY (PTA)
Entity Type:Individual
Prefix:
First Name:MARGARET
Middle Name:MARY
Last Name:RONCOLATO
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:206 N 5TH ST
Mailing Address - Street 2:
Mailing Address - City:EMMAUS
Mailing Address - State:PA
Mailing Address - Zip Code:18049-2410
Mailing Address - Country:US
Mailing Address - Phone:610-965-5873
Mailing Address - Fax:
Practice Address - Street 1:1200 SPRING ST
Practice Address - Street 2:
Practice Address - City:BETHLEHEM
Practice Address - State:PA
Practice Address - Zip Code:18018-4940
Practice Address - Country:US
Practice Address - Phone:610-865-5595
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PATE000569L225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant