Provider Demographics
NPI:1790920338
Name:TAREILA, MARGARET MARY (PT)
Entity Type:Individual
Prefix:MRS
First Name:MARGARET
Middle Name:MARY
Last Name:TAREILA
Suffix:
Gender:F
Credentials:PT
Other - Prefix:MISS
Other - First Name:MARGARET
Other - Middle Name:MARY
Other - Last Name:MCCONVILLE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:415 BRIARWOOD RD
Mailing Address - Street 2:
Mailing Address - City:WALLINGFORD
Mailing Address - State:PA
Mailing Address - Zip Code:19086-6502
Mailing Address - Country:US
Mailing Address - Phone:610-566-4167
Mailing Address - Fax:
Practice Address - Street 1:1001 BALTIMORE PIKE
Practice Address - Street 2:SUITE 301
Practice Address - City:SPRINGFIELD
Practice Address - State:PA
Practice Address - Zip Code:19064-2852
Practice Address - Country:US
Practice Address - Phone:610-690-2520
Practice Address - Fax:610-690-4645
Is Sole Proprietor?:No
Enumeration Date:2008-12-11
Last Update Date:2008-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT003358L225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist