Provider Demographics
NPI:1659516656
Name:CIRILLO, CATHERINE (BS, PT)
Entity Type:Individual
Prefix:MRS
First Name:CATHERINE
Middle Name:
Last Name:CIRILLO
Suffix:
Gender:F
Credentials:BS, PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:520 ELLSWORTH AVE APT 2C
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10465-1742
Mailing Address - Country:US
Mailing Address - Phone:917-682-5033
Mailing Address - Fax:
Practice Address - Street 1:520 ELLSWORTH AVE APT 2C
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10465-1742
Practice Address - Country:US
Practice Address - Phone:917-682-5033
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-12-05
Last Update Date:2019-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY011591225100000X
NY011591-1225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist