Provider Demographics
NPI:1194786012
Name:CRISTOFALO, SHARON M (PT)
Entity type:Individual
Prefix:
First Name:SHARON
Middle Name:M
Last Name:CRISTOFALO
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 1:393 TOWNSHIP LINE RD
Mailing Address - Street 2:
Mailing Address - City:CHALFONT
Mailing Address - State:PA
Mailing Address - Zip Code:18914-1428
Mailing Address - Country:US
Mailing Address - Phone:215-340-2216
Mailing Address - Fax:
Practice Address - Street 1:924 TOWN CTR
Practice Address - Street 2:
Practice Address - City:NEW BRITAIN
Practice Address - State:PA
Practice Address - Zip Code:18901-5182
Practice Address - Country:US
Practice Address - Phone:215-340-2216
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-03-30
Last Update Date:2009-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT011523L225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA950446OtherBLUE CROSS BLUE SHIELD
PA1113975OtherUNITED HEALTHCARE
PA1160631OtherKEYSTONE MERCY HEALTH PLA
PA100841180Medicaid