Provider Demographics
NPI:1215131537
Name:PARAVICINI, DAWN MARIE
Entity type:Individual
Prefix:
First Name:DAWN
Middle Name:MARIE
Last Name:PARAVICINI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:DAWN
Other - Middle Name:MARIE
Other - Last Name:PARAVICINI KOSMORSKY
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:1339 HELLER DRIVE
Mailing Address - Street 2:
Mailing Address - City:YARDLEY
Mailing Address - State:PA
Mailing Address - Zip Code:19067
Mailing Address - Country:US
Mailing Address - Phone:215-321-4331
Mailing Address - Fax:
Practice Address - Street 1:304 FLORAL VALE BLVD
Practice Address - Street 2:
Practice Address - City:YARDLEY
Practice Address - State:PA
Practice Address - Zip Code:19067
Practice Address - Country:US
Practice Address - Phone:215-860-7246
Practice Address - Fax:215-860-7933
Is Sole Proprietor?:No
Enumeration Date:2007-06-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT005569L225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist