Provider Demographics
NPI:1578375515
Name:SCIULLI, MICHELLE RENEE (PT,DPT)
Entity type:Individual
Prefix:
First Name:MICHELLE
Middle Name:RENEE
Last Name:SCIULLI
Suffix:
Gender:F
Credentials:PT,DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:102 UNION AVE
Mailing Address - Street 2:
Mailing Address - City:CRAFTON
Mailing Address - State:PA
Mailing Address - Zip Code:15205-2726
Mailing Address - Country:US
Mailing Address - Phone:412-860-0495
Mailing Address - Fax:
Practice Address - Street 1:566 PINE HOLLOW RD
Practice Address - Street 2:
Practice Address - City:MC KEES ROCKS
Practice Address - State:PA
Practice Address - Zip Code:15136-1661
Practice Address - Country:US
Practice Address - Phone:412-771-1055
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-01-27
Last Update Date:2025-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT032966225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty