Provider Demographics
NPI:1013355205
Name:PAVLO, MARIA KATHLEEN
Entity Type:Individual
Prefix:
First Name:MARIA
Middle Name:KATHLEEN
Last Name:PAVLO
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 1:4673 SMITH DR
Mailing Address - Street 2:
Mailing Address - City:BETHLEHEM
Mailing Address - State:PA
Mailing Address - Zip Code:18017-8766
Mailing Address - Country:US
Mailing Address - Phone:610-837-6147
Mailing Address - Fax:
Practice Address - Street 1:4673 SMITH DR
Practice Address - Street 2:
Practice Address - City:BETHLEHEM
Practice Address - State:PA
Practice Address - Zip Code:18017-8766
Practice Address - Country:US
Practice Address - Phone:610-837-6147
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-06-10
Last Update Date:2013-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer