Provider Demographics
NPI:1124355680
Name:NEFF, NICOLE PINAMONTI (PT)
Entity type:Individual
Prefix:
First Name:NICOLE
Middle Name:PINAMONTI
Last Name:NEFF
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25 CAMP GREEN LANE RD
Mailing Address - Street 2:
Mailing Address - City:GREEN LANE
Mailing Address - State:PA
Mailing Address - Zip Code:18054-2302
Mailing Address - Country:US
Mailing Address - Phone:631-848-7927
Mailing Address - Fax:
Practice Address - Street 1:25 CAMP GREEN LANE RD
Practice Address - Street 2:
Practice Address - City:GREEN LANE
Practice Address - State:PA
Practice Address - Zip Code:18054-2302
Practice Address - Country:US
Practice Address - Phone:631-848-7927
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-11-04
Last Update Date:2022-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ8869225100000X
PADAPT003251225100000X
PAPT024339225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZZ147332Medicare PIN