MEDICARE: MISS NICOLE AMATUZZO MSPT

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	2251P0200X	Pediatric Physical Therapist	026240-1	NY

General Provider Information

NPI Number	:	1528212859
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MISS NICOLE AMATUZZO MSPT

Provider Business Mailing Address
First Line	:	273 ELVERTON AVE
Second Line	:
City	:	STATEN ISLAND
State	:	NY
Zip	:	10308-1530
Country	:	US
Telephone Number	:	718-948-3623
Fax Number	:

Provider Business Practice Location Address
First Line	:	273 ELVERTON AVE
Second Line	:
City	:	STATEN ISLAND
State	:	NY
Zip	:	10308-1530
Country	:	US
Telephone Number	:	718-948-3623
Fax Number	:

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

Provider Enumeration Date	:	11/13/2008
Last Update Date	:	11/13/2008

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Directions to “ MISS NICOLE AMATUZZO MSPT” Practice Location

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