Provider Demographics
NPI:1376261511
Name:CORWIN, GILLIAN (DPT)
Entity Type:Individual
Prefix:
First Name:GILLIAN
Middle Name:
Last Name:CORWIN
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:GILLIAN
Other - Middle Name:
Other - Last Name:LAMB
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DPT
Mailing Address - Street 1:60 FINN RD STE C
Mailing Address - Street 2:
Mailing Address - City:HENRIETTA
Mailing Address - State:NY
Mailing Address - Zip Code:14467-9391
Mailing Address - Country:US
Mailing Address - Phone:585-444-0040
Mailing Address - Fax:
Practice Address - Street 1:60 FINN RD STE C
Practice Address - Street 2:
Practice Address - City:HENRIETTA
Practice Address - State:NY
Practice Address - Zip Code:14467-9391
Practice Address - Country:US
Practice Address - Phone:585-444-0040
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-08-15
Last Update Date:2023-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY048958225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist