Provider Demographics
NPI:1881630960
Name:GIULIANI, MICHAEL QUINTO (PT MPT,PHD)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:QUINTO
Last Name:GIULIANI
Suffix:
Gender:M
Credentials:PT MPT,PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:109 KENT DR
Mailing Address - Street 2:
Mailing Address - City:NORTH WALES
Mailing Address - State:PA
Mailing Address - Zip Code:19454-1926
Mailing Address - Country:US
Mailing Address - Phone:215-661-8446
Mailing Address - Fax:215-661-8426
Practice Address - Street 1:1345 EASTON RD
Practice Address - Street 2:
Practice Address - City:ROSLYN
Practice Address - State:PA
Practice Address - Zip Code:19001-2401
Practice Address - Country:US
Practice Address - Phone:215-885-2033
Practice Address - Fax:215-885-7408
Is Sole Proprietor?:No
Enumeration Date:2006-06-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT007728L225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
4319553OtherAETNA HEALTH PLAN
0139879000OtherINDEPENDENCE BLUE CROSS
0001073672-02OtherUNITED HEALTH CARE
1112852OtherKEYSTONE MERCY
PA01618281Medicaid