Healthcare Provider Details

I. General information

NPI: 1962491977
Provider Name (Legal Business Name): JONNA A LAMARCO PT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: JONNA L AIELLO PT

II. Dates (important events)

Enumeration Date: 10/21/2005
Last Update Date: 12/09/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

679 STARK TER
BALLSTON SPA NY
12020-3073
US

IV. Provider business mailing address

679 STARK TER
BALLSTON SPA NY
12020-3073
US

V. Phone/Fax

Practice location:
  • Phone: 518-588-9434
  • Fax: 518-587-2567
Mailing address:
  • Phone: 518-588-9434
  • Fax: 518-587-2567

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: