Provider Demographics
NPI:1790188167
Name:FERRERI-STAFFILENO, PATRICIA JEAN
Entity type:Individual
Prefix:
First Name:PATRICIA
Middle Name:JEAN
Last Name:FERRERI-STAFFILENO
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 1:9311 WISNER RD
Mailing Address - Street 2:
Mailing Address - City:CHARDON
Mailing Address - State:OH
Mailing Address - Zip Code:44024-9606
Mailing Address - Country:US
Mailing Address - Phone:216-973-1815
Mailing Address - Fax:
Practice Address - Street 1:15600 PARKLAND DR
Practice Address - Street 2:
Practice Address - City:SHAKER HEIGHTS
Practice Address - State:OH
Practice Address - Zip Code:44120-2529
Practice Address - Country:US
Practice Address - Phone:216-295-4070
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-09-30
Last Update Date:2014-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHOT-1394225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist