Healthcare Provider Details

I. General information

NPI: 1649523507
Provider Name (Legal Business Name): EMILY PAFF PT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/17/2012
Last Update Date: 10/17/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3109 UNIVERSITY AVE STE C SELLARO PLAZA
MORGANTOWN WV
26505-3205
US

IV. Provider business mailing address

625 LINCOLN AVE STE 107 PROFESSIONAL PLAZA
CHARLEROI PA
15022-2451
US

V. Phone/Fax

Practice location:
  • Phone: 304-241-4020
  • Fax: 304-241-4029
Mailing address:
  • Phone: 724-483-1673
  • Fax: 724-483-0290

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT022367
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT003050
License Number StateWV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: