Provider Demographics
NPI:1902529837
Name:TUZZOLO, JOAN E
Entity Type:Individual
Prefix:
First Name:JOAN
Middle Name:E
Last Name:TUZZOLO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:120 HICKORY RD
Mailing Address - Street 2:
Mailing Address - City:DINGMANS FERRY
Mailing Address - State:PA
Mailing Address - Zip Code:18328-3102
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:404 E HARFORD ST
Practice Address - Street 2:
Practice Address - City:MILFORD
Practice Address - State:PA
Practice Address - Zip Code:18337-1028
Practice Address - Country:US
Practice Address - Phone:570-409-3593
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-09-26
Last Update Date:2022-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOP010315224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant