Provider Demographics
NPI:1013072784
Name:FARENO, MICHELE SUSAN
Entity Type:Individual
Prefix:MRS
First Name:MICHELE
Middle Name:SUSAN
Last Name:FARENO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:123 STATESMAN RD
Mailing Address - Street 2:
Mailing Address - City:CHALFONT
Mailing Address - State:PA
Mailing Address - Zip Code:18914-3580
Mailing Address - Country:US
Mailing Address - Phone:215-822-2029
Mailing Address - Fax:
Practice Address - Street 1:123 STATESMAN RD
Practice Address - Street 2:
Practice Address - City:CHALFONT
Practice Address - State:PA
Practice Address - Zip Code:18914-3580
Practice Address - Country:US
Practice Address - Phone:215-822-2029
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT011009L225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist