Provider Demographics
NPI:1245644939
Name:CILLUFFO, GLORIA (PT)
Entity type:Individual
Prefix:
First Name:GLORIA
Middle Name:
Last Name:CILLUFFO
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:343 OLD BAILEY LN
Mailing Address - Street 2:
Mailing Address - City:WEST CHESTER
Mailing Address - State:PA
Mailing Address - Zip Code:19382-8491
Mailing Address - Country:US
Mailing Address - Phone:610-304-2454
Mailing Address - Fax:
Practice Address - Street 1:412 CREAMERY WAY
Practice Address - Street 2:SUITE 300
Practice Address - City:EXTON
Practice Address - State:PA
Practice Address - Zip Code:19341-2551
Practice Address - Country:US
Practice Address - Phone:484-875-0200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-06-20
Last Update Date:2014-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT019259225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist