Provider Demographics
NPI:1447404652
Name:MAGNOTTA, EILEEN F (PT)
Entity Type:Individual
Prefix:MRS
First Name:EILEEN
Middle Name:F
Last Name:MAGNOTTA
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:27 KENTWOOD DR
Mailing Address - Street 2:
Mailing Address - City:CARMEL
Mailing Address - State:NY
Mailing Address - Zip Code:10512-4032
Mailing Address - Country:US
Mailing Address - Phone:914-906-2312
Mailing Address - Fax:
Practice Address - Street 1:27 KENTWOOD DRIVE
Practice Address - Street 2:
Practice Address - City:CARMEL
Practice Address - State:NY
Practice Address - Zip Code:10512-4032
Practice Address - Country:US
Practice Address - Phone:914-906-2312
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-11-14
Last Update Date:2017-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY010226-12251P0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatrics