Provider Demographics
NPI:1265001275
Name:VELTRI-PETROSINO, NICOLE ANN (DPT)
Entity Type:Individual
Prefix:
First Name:NICOLE
Middle Name:ANN
Last Name:VELTRI-PETROSINO
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:NICOLE
Other - Middle Name:ANN
Other - Last Name:VELTRI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5823 WIDEWATERS PKWY STE 3
Mailing Address - Street 2:
Mailing Address - City:EAST SYRACUSE
Mailing Address - State:NY
Mailing Address - Zip Code:13057-3081
Mailing Address - Country:US
Mailing Address - Phone:315-418-4013
Mailing Address - Fax:315-478-0388
Practice Address - Street 1:5823 WIDEWATERS PKWY STE 3
Practice Address - Street 2:
Practice Address - City:EAST SYRACUSE
Practice Address - State:NY
Practice Address - Zip Code:13057-3081
Practice Address - Country:US
Practice Address - Phone:315-418-4013
Practice Address - Fax:315-478-0388
Is Sole Proprietor?:No
Enumeration Date:2021-06-23
Last Update Date:2023-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY046771225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist