Provider Demographics
NPI:1538173075
Name:RICUPERO, JULIANA MARIE (PT)
Entity type:Individual
Prefix:MRS
First Name:JULIANA
Middle Name:MARIE
Last Name:RICUPERO
Suffix:
Gender:F
Credentials:PT
Other - Prefix:MRS
Other - First Name:JULIANA
Other - Middle Name:MARIE
Other - Last Name:INMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSPT
Mailing Address - Street 1:1454 SCALP AVE
Mailing Address - Street 2:
Mailing Address - City:JOHNSTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:15904-3321
Mailing Address - Country:US
Mailing Address - Phone:814-266-8833
Mailing Address - Fax:814-269-3385
Practice Address - Street 1:1454 SCALP AVE
Practice Address - Street 2:
Practice Address - City:JOHNSTOWN
Practice Address - State:PA
Practice Address - Zip Code:15904-3321
Practice Address - Country:US
Practice Address - Phone:814-266-8833
Practice Address - Fax:814-269-3385
Is Sole Proprietor?:No
Enumeration Date:2006-07-28
Last Update Date:2009-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT015833225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist