Provider Demographics
NPI:1326131822
Name:SCIORILLI, DIANNA M (PT)
Entity Type:Individual
Prefix:
First Name:DIANNA
Middle Name:M
Last Name:SCIORILLI
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:DIANNA
Other - Middle Name:M
Other - Last Name:MIEREK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2209 GENESEE STREET
Mailing Address - Street 2:BUSINESS OFFICE ROOM 310
Mailing Address - City:UTICA
Mailing Address - State:NY
Mailing Address - Zip Code:13501-5930
Mailing Address - Country:US
Mailing Address - Phone:315-801-3282
Mailing Address - Fax:315-801-8391
Practice Address - Street 1:1676 SUNSET AVE
Practice Address - Street 2:
Practice Address - City:UTICA
Practice Address - State:NY
Practice Address - Zip Code:13502-5416
Practice Address - Country:US
Practice Address - Phone:315-624-5400
Practice Address - Fax:315-624-5395
Is Sole Proprietor?:No
Enumeration Date:2006-10-02
Last Update Date:2018-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY025193225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY70051AOtherMEDICARE GROUP NUMBER
NY00279901OtherMEDICAID GROUP NUMBER