Provider Demographics
NPI:1003881079
Name:MARAGIOGLIO, AMY W (PT, ATC)
Entity Type:Individual
Prefix:MRS
First Name:AMY
Middle Name:W
Last Name:MARAGIOGLIO
Suffix:
Gender:F
Credentials:PT, ATC
Other - Prefix:MS
Other - First Name:AMY
Other - Middle Name:E
Other - Last Name:WINDRUM
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT, ATC
Mailing Address - Street 1:270 N DUNTON AVE
Mailing Address - Street 2:
Mailing Address - City:EAST PATCHOGUE
Mailing Address - State:NY
Mailing Address - Zip Code:11772-5545
Mailing Address - Country:US
Mailing Address - Phone:631-654-0561
Mailing Address - Fax:
Practice Address - Street 1:607 MIDDLE COUNTRY ROAD
Practice Address - Street 2:
Practice Address - City:CORAM
Practice Address - State:NY
Practice Address - Zip Code:11727
Practice Address - Country:US
Practice Address - Phone:631-732-3900
Practice Address - Fax:631-732-3908
Is Sole Proprietor?:No
Enumeration Date:2006-02-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY024244-1225100000X
NY000607-12255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Not Answered2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer
Provider Identifiers
StateIdentifier IDID TypeIssuer
7513738OtherAETNA PPO
1140321OtherAETNA HMO
7513738OtherAETNA PPO