Provider Demographics
NPI:1891789871
Name:PILATO, MICHAEL L (MS AT,C)
Entity Type:Individual
Prefix:MR
First Name:MICHAEL
Middle Name:L
Last Name:PILATO
Suffix:
Gender:M
Credentials:MS AT,C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1055 LARKSTON DR
Mailing Address - Street 2:
Mailing Address - City:WEBSTER
Mailing Address - State:NY
Mailing Address - Zip Code:14580-8621
Mailing Address - Country:US
Mailing Address - Phone:585-329-6463
Mailing Address - Fax:
Practice Address - Street 1:1055 LARKSTON DR
Practice Address - Street 2:
Practice Address - City:WEBSTER
Practice Address - State:NY
Practice Address - Zip Code:14580-8621
Practice Address - Country:US
Practice Address - Phone:585-329-6463
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-09-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY000093-12255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer