MEDICARE: BENITO GIAMPAGLIA PT,MTC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2251X0800X	Orthopedic Physical Therapist	0121701	NY

General Provider Information

NPI Number	:	1528039492
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BENITO GIAMPAGLIA PT,MTC

Provider Business Mailing Address
First Line	:	1053 SAW MILL RIVER RD
Second Line	:	SUITE105
City	:	ARDSLEY
State	:	NY
Zip	:	10502-1048
Country	:	US
Telephone Number	:	914-693-2350
Fax Number	:	914-693-7661

Provider Business Practice Location Address
First Line	:	1053 SAW MILL RIVER RD
Second Line	:	SUITE105
City	:	ARDSLEY
State	:	NY
Zip	:	10502-1048
Country	:	US
Telephone Number	:	914-693-2350
Fax Number	:	914-693-7661

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/30/2006
Last Update Date	:	10/19/2007

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