MEDICARE: AMY GEMIGNANI SAN FILIPPO MPT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist	10687	OH

General Provider Information

NPI Number	:	1275648966
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AMY GEMIGNANI SAN FILIPPO MPT

Provider Business Mailing Address
First Line	:	1535 SUNFLOWER ST
Second Line	:
City	:	LEWIS CENTER
State	:	OH
Zip	:	43035-7205
Country	:	US
Telephone Number	:	740-549-2903
Fax Number	:

Provider Business Practice Location Address
First Line	:	6021 CLEVELAND AVE
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43231-2256
Country	:	US
Telephone Number	:	614-895-1090
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/20/2006
Last Update Date	:	07/08/2007

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