Provider Demographics
NPI:1902828528
Name:FERRAIOLI, AIMEE LISA (MPT)
Entity Type:Individual
Prefix:MRS
First Name:AIMEE
Middle Name:LISA
Last Name:FERRAIOLI
Suffix:
Gender:F
Credentials:MPT
Other - Prefix:
Other - First Name:AIMEE
Other - Middle Name:LISA
Other - Last Name:SHILOFF
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MPT
Mailing Address - Street 1:12 RACHEL CT
Mailing Address - Street 2:
Mailing Address - City:JACKSON
Mailing Address - State:NJ
Mailing Address - Zip Code:08527-2410
Mailing Address - Country:US
Mailing Address - Phone:732-513-6464
Mailing Address - Fax:
Practice Address - Street 1:162 JOYSAN TER
Practice Address - Street 2:
Practice Address - City:FREEHOLD
Practice Address - State:NJ
Practice Address - Zip Code:07728-9304
Practice Address - Country:US
Practice Address - Phone:908-331-1654
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-24
Last Update Date:2013-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA00786800225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ076524UQ3Medicare ID - Type Unspecified
NJ079907Medicare PIN