Provider Demographics
NPI:1063678373
Name:TORNCELLO, VIRGINIA LUANNE
Entity Type:Individual
Prefix:
First Name:VIRGINIA
Middle Name:LUANNE
Last Name:TORNCELLO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3 WALLBROOK CT
Mailing Address - Street 2:
Mailing Address - City:COHOES
Mailing Address - State:NY
Mailing Address - Zip Code:12047-4967
Mailing Address - Country:US
Mailing Address - Phone:518-608-6365
Mailing Address - Fax:518-608-6365
Practice Address - Street 1:3 WALLBROOK CT
Practice Address - Street 2:
Practice Address - City:COHOES
Practice Address - State:NY
Practice Address - Zip Code:12047-4967
Practice Address - Country:US
Practice Address - Phone:518-608-6365
Practice Address - Fax:518-608-6365
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-06
Last Update Date:2008-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY009539-12251P0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatrics