Provider Demographics
NPI:1588760722
Name:PACILLO, CINDY (DC)
Entity type:Individual
Prefix:
First Name:CINDY
Middle Name:
Last Name:PACILLO
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:70 E SHENANGO ST
Mailing Address - Street 2:
Mailing Address - City:SHARPSVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:16150-1122
Mailing Address - Country:US
Mailing Address - Phone:724-962-9967
Mailing Address - Fax:724-962-9968
Practice Address - Street 1:70 E SHENANGO ST
Practice Address - Street 2:
Practice Address - City:SHARPSVILLE
Practice Address - State:PA
Practice Address - Zip Code:16150-1122
Practice Address - Country:US
Practice Address - Phone:724-962-9967
Practice Address - Fax:724-962-9968
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC007836L111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0019227450002Medicaid
PA624022OtherBCBS
PA0019227450002Medicaid
PA624022OtherBCBS