Provider Demographics
NPI:1912299454
Name:CIOFALO, MICHELE (OTR)
Entity Type:Individual
Prefix:MRS
First Name:MICHELE
Middle Name:
Last Name:CIOFALO
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3032 EDMONDS RD
Mailing Address - Street 2:
Mailing Address - City:LAFAYETTE HILL
Mailing Address - State:PA
Mailing Address - Zip Code:19444-2032
Mailing Address - Country:US
Mailing Address - Phone:610-216-7023
Mailing Address - Fax:
Practice Address - Street 1:3032 EDMONDS RD
Practice Address - Street 2:
Practice Address - City:LAFAYETTE HILL
Practice Address - State:PA
Practice Address - Zip Code:19444-2032
Practice Address - Country:US
Practice Address - Phone:610-216-7023
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-05-03
Last Update Date:2011-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOC002309L225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist