Provider Demographics
NPI:1962780718
Name:PILOSI, DAWN MARIE (COTA/L)
Entity type:Individual
Prefix:MS
First Name:DAWN
Middle Name:MARIE
Last Name:PILOSI
Suffix:
Gender:F
Credentials:COTA/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:133 PETTEBONE ST
Mailing Address - Street 2:
Mailing Address - City:DURYEA
Mailing Address - State:PA
Mailing Address - Zip Code:18642-1329
Mailing Address - Country:US
Mailing Address - Phone:570-357-9364
Mailing Address - Fax:
Practice Address - Street 1:108 TERRACE DR
Practice Address - Street 2:
Practice Address - City:OLYPHANT
Practice Address - State:PA
Practice Address - Zip Code:18447-2503
Practice Address - Country:US
Practice Address - Phone:570-489-8611
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-07-28
Last Update Date:2011-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOP003500L224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAOP003500LOtherSTATE