Healthcare Provider Details

I. General information

NPI: 1740929504
Provider Name (Legal Business Name): AMALIA A PILANO EP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/31/2022
Last Update Date: 05/31/2022
Certification Date: 05/31/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9150 GRAMERCY DR UNIT 289
SAN DIEGO CA
92123-4001
US

IV. Provider business mailing address

9150 GRAMERCY DR UNIT 289
SAN DIEGO CA
92123-4001
US

V. Phone/Fax

Practice location:
  • Phone: 914-514-0848
  • Fax:
Mailing address:
  • Phone: 914-514-0848
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code224Y00000X
TaxonomyClinical Exercise Physiologist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: