Healthcare Provider Details

I. General information

NPI: 1902887326
Provider Name (Legal Business Name): KELLY MARIE GIGLIO M.S.P.T.
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 11/11/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2 DELAVERGNE AVE C/O CENTER FOR PHYSICAL THERAPY
WAPPINGERS FALLS NY
12590-1202
US

IV. Provider business mailing address

2 DELAVERGNE AVE C/O CENTER FOR PHYSICAL THERAPY
WAPPINGERS FALLS NY
12590-1202
US

V. Phone/Fax

Practice location:
  • Phone: 845-297-4789
  • Fax: 845-297-8596
Mailing address:
  • Phone: 845-297-4789
  • Fax: 845-297-8596

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2251P0200X
TaxonomyPediatric Physical Therapist
License Number022350
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: