Provider Demographics
NPI:1366286148
Name:DE PLATO, MIA
Entity type:Individual
Prefix:
First Name:MIA
Middle Name:
Last Name:DE PLATO
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 1:339 SPRING MILL AVE
Mailing Address - Street 2:
Mailing Address - City:CONSHOHOCKEN
Mailing Address - State:PA
Mailing Address - Zip Code:19428-1945
Mailing Address - Country:US
Mailing Address - Phone:610-930-8779
Mailing Address - Fax:
Practice Address - Street 1:8100 WASHINGTON LN
Practice Address - Street 2:
Practice Address - City:WYNCOTE
Practice Address - State:PA
Practice Address - Zip Code:19095-1600
Practice Address - Country:US
Practice Address - Phone:215-576-8000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-06-25
Last Update Date:2024-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist