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NPI Code Detail

MEDICARE: MRS. MARY PIVIROTTO PT

MEDICARE: MRS. MARY PIVIROTTO PT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225100000XPhysical TherapistPT005440LPA

General Provider Information

NPI Number : 1053500934
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. MARY PIVIROTTO PT
Provider Business Mailing Address
First Line : 58 BURNSIDE DR
Second Line :
City : EAST BERLIN
State : PA
Zip : 17316-9384
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 2990 CARLISLE PIKE
Second Line :
City : NEW OXFORD
State : PA
Zip : 17350-9582
Country : US
Telephone Number : 717-624-5229
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/17/2007
Last Update Date : 10/17/2007

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