Healthcare Provider Details

I. General information

NPI: 1144155482
Provider Name (Legal Business Name): JANICE DIGIACOMO ATC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/17/2026
Last Update Date: 06/17/2026
Certification Date: 06/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

30 PARROTT RD
WEST NYACK NY
10994-1045
US

IV. Provider business mailing address

201 N MAIN ST
NEW CITY NY
10956-3709
US

V. Phone/Fax

Practice location:
  • Phone: 845-558-1394
  • Fax:
Mailing address:
  • Phone: 845-558-1394
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2255A2300X
TaxonomyAthletic Trainer
License Number000582
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: