Provider Demographics
NPI:1023532793
Name:CILLO, JOSHUA DAVID (AUD)
Entity type:Individual
Prefix:DR
First Name:JOSHUA
Middle Name:DAVID
Last Name:CILLO
Suffix:
Gender:M
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1138 MULBERRY ST
Mailing Address - Street 2:
Mailing Address - City:MONTOURSVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:17754-2112
Mailing Address - Country:US
Mailing Address - Phone:570-419-3373
Mailing Address - Fax:
Practice Address - Street 1:2298 OCEAN HWY W # 17
Practice Address - Street 2:
Practice Address - City:SUPPLY
Practice Address - State:NC
Practice Address - Zip Code:28462-4024
Practice Address - Country:US
Practice Address - Phone:910-755-2428
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-08-03
Last Update Date:2017-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist