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General NPI Number Information
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NPI Number | 1588800395
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Entity Type | Individual
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Provider Name | DEBRA J. R. CORCIMIGLIA L.M.T.
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Gender | Female
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Dates
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Enumeration Date | 12/29/2008
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Last Update Date | 12/29/2008
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Provider Practice Location Address
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Address Line | 243 W MAIN ST
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City | SPRINGVILLE
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State | NY
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Zip | 14141-1089
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Country | US
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Telephone | 716-560-9884
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Fax | 716-592-3559
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Provider Business Mailing Address
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Address Line | 128 MYRTLE AVE
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City | SPRINGVILLE
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State | NY
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Zip | 14141-1218
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Country | US
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Telephone | 716-560-9884
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Fax | 716-592-3559
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225700000X
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Taxonomy Name | Massage Therapist
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License Number | 008843-1
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License Number State | NY
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