Healthcare Provider Details

I. General information

NPI: 1821138876
Provider Name (Legal Business Name): KELLY ANN CIRINO P.T.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/07/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3411 SILVERSIDE RD. SUITE 105 SPRINGER BLD.
WILMINGTON DE
19810
US

IV. Provider business mailing address

140 DEN RD
LINCOLN UNIVERSITY PA
19352-1222
US

V. Phone/Fax

Practice location:
  • Phone: 302-478-5240
  • Fax: 302-478-2592
Mailing address:
  • Phone: 610-255-3580
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberJ1-0000459
License Number StateDE
# 2
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT005343L
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: