Provider Demographics
NPI:1942519772
Name:CHACKO, JULIANN MICHELLE
Entity type:Individual
Prefix:
First Name:JULIANN
Middle Name:MICHELLE
Last Name:CHACKO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:JULIANN
Other - Middle Name:MICHELLE
Other - Last Name:KAPLOW
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2870 TALLEY CAVEY RD
Mailing Address - Street 2:PILSUNG PLAZA, SUITE 100
Mailing Address - City:ALLISON PARK
Mailing Address - State:PA
Mailing Address - Zip Code:15101-2448
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2870 TALLEY CAVEY RD
Practice Address - Street 2:PILSUNG PLAZA, SUITE 100
Practice Address - City:ALLISON PARK
Practice Address - State:PA
Practice Address - Zip Code:15101-2448
Practice Address - Country:US
Practice Address - Phone:412-487-4710
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-09-28
Last Update Date:2012-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT020846225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist