Provider Demographics
NPI:1205157575
Name:CONCIALDI, PERRI-ANNE PILLOT (CNP)
Entity type:Individual
Prefix:MRS
First Name:PERRI-ANNE
Middle Name:PILLOT
Last Name:CONCIALDI
Suffix:
Gender:F
Credentials:CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4051 LINCOLN WAY E
Mailing Address - Street 2:
Mailing Address - City:MASSILLON
Mailing Address - State:OH
Mailing Address - Zip Code:44646-3770
Mailing Address - Country:US
Mailing Address - Phone:330-477-8770
Mailing Address - Fax:330-477-5613
Practice Address - Street 1:4051 LINCOLN WAY E
Practice Address - Street 2:
Practice Address - City:MASSILLON
Practice Address - State:OH
Practice Address - Zip Code:44646-3770
Practice Address - Country:US
Practice Address - Phone:330-477-8770
Practice Address - Fax:330-477-5613
Is Sole Proprietor?:No
Enumeration Date:2010-06-21
Last Update Date:2010-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH183949-COA2363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health