Provider Demographics
NPI:1689851545
Name:PERFILIO PAMELIA, CAROL ANN C (DC)
Entity Type:Individual
Prefix:DR
First Name:CAROL ANN
Middle Name:C
Last Name:PERFILIO PAMELIA
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1328 PROVIDENCE RD
Mailing Address - Street 2:
Mailing Address - City:SCRANTON
Mailing Address - State:PA
Mailing Address - Zip Code:18508
Mailing Address - Country:US
Mailing Address - Phone:570-347-3677
Mailing Address - Fax:570-347-3677
Practice Address - Street 1:1328 PROVIDENCE RD
Practice Address - Street 2:
Practice Address - City:SCRANTON
Practice Address - State:PA
Practice Address - Zip Code:18508
Practice Address - Country:US
Practice Address - Phone:570-347-3677
Practice Address - Fax:570-347-3677
Is Sole Proprietor?:No
Enumeration Date:2008-01-23
Last Update Date:2008-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC001562L111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
98082OtherPROVIDER ID
98082OtherPROVIDER ID