Provider Demographics
NPI:1376849646
Name:CIMORELLI, JOANNE E (RDH)
Entity Type:Individual
Prefix:
First Name:JOANNE
Middle Name:E
Last Name:CIMORELLI
Suffix:
Gender:F
Credentials:RDH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:504 AVALON PL
Mailing Address - Street 2:
Mailing Address - City:COHOES
Mailing Address - State:NY
Mailing Address - Zip Code:12047-1763
Mailing Address - Country:US
Mailing Address - Phone:518-326-2993
Mailing Address - Fax:
Practice Address - Street 1:40 WALL ST
Practice Address - Street 2:
Practice Address - City:AMSTERDAM
Practice Address - State:NY
Practice Address - Zip Code:12010-4309
Practice Address - Country:US
Practice Address - Phone:518-843-2575
Practice Address - Fax:518-842-9592
Is Sole Proprietor?:No
Enumeration Date:2011-02-04
Last Update Date:2011-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY011244124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist