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General NPI Number Information
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NPI Number | 1659889129
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Entity Type | Individual
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Provider Name | JOSEPH MICHAEL GIACOMO PT, DPT, ATC/L, CSCS
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Gender | Male
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Dates
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Enumeration Date | 01/17/2018
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Last Update Date | 08/28/2022
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Provider Practice Location Address
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Address Line | 1 BRIDGE ST STE 71
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City | IRVINGTON
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State | NY
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Zip | 10533-1560
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Country | US
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Telephone | 914-815-2484
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Fax |
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Provider Business Mailing Address
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Address Line | 132 E STEVENS AVE
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City | VALHALLA
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State | NY
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Zip | 10595-1204
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Country | US
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Telephone |
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Fax |
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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 | 2255A2300X
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Taxonomy Name | Athletic Trainer
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 049109
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License Number State | NY
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Taxonomy #3
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 013536
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License Number State | CT
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Taxonomy #4
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Taxonomy Code | 2251X0800X
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Taxonomy Name | Orthopedic Physical Therapist
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License Number | 049109
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License Number State | NY
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Taxonomy #5
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Taxonomy Code | 2255A2300X
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Taxonomy Name | Athletic Trainer
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License Number | 003884
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License Number State | NY
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Taxonomy #6
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Taxonomy Code | 2255A2300X
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Taxonomy Name | Athletic Trainer
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License Number | 001604
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License Number State | CT
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