Provider Demographics
NPI:1013445279
Name:PUZIO, MICHELE ANTOINETTE (MSPT)
Entity Type:Individual
Prefix:MRS
First Name:MICHELE
Middle Name:ANTOINETTE
Last Name:PUZIO
Suffix:
Gender:F
Credentials:MSPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:185 THOMPSON DR
Mailing Address - Street 2:
Mailing Address - City:HOCKESSIN
Mailing Address - State:DE
Mailing Address - Zip Code:19707-1913
Mailing Address - Country:US
Mailing Address - Phone:302-635-7079
Mailing Address - Fax:
Practice Address - Street 1:7460 LANCASTER PIKE STE 8
Practice Address - Street 2:
Practice Address - City:HOCKESSIN
Practice Address - State:DE
Practice Address - Zip Code:19707-9276
Practice Address - Country:US
Practice Address - Phone:302-234-4045
Practice Address - Fax:302-234-4046
Is Sole Proprietor?:Yes
Enumeration Date:2017-05-31
Last Update Date:2017-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEJ1-0001655225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist