Provider Demographics
NPI:1902556186
Name:PISANO, ABAGAIL (OTR/L)
Entity Type:Individual
Prefix:
First Name:ABAGAIL
Middle Name:
Last Name:PISANO
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3533 JOSEPH DR
Mailing Address - Street 2:
Mailing Address - City:ERIE
Mailing Address - State:PA
Mailing Address - Zip Code:16506-6033
Mailing Address - Country:US
Mailing Address - Phone:440-645-9045
Mailing Address - Fax:
Practice Address - Street 1:17990 W LAKE HOUSTON PKWY
Practice Address - Street 2:
Practice Address - City:ATASCOCITA
Practice Address - State:TX
Practice Address - Zip Code:77346-5195
Practice Address - Country:US
Practice Address - Phone:281-612-3585
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-03-28
Last Update Date:2022-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist