Provider Demographics
NPI:1508405390
Name:IANNOTTI, BRIANNE L
Entity Type:Individual
Prefix:
First Name:BRIANNE
Middle Name:L
Last Name:IANNOTTI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:BRIANNE
Other - Middle Name:L
Other - Last Name:CRAMER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:7 PERKINS ST
Mailing Address - Street 2:
Mailing Address - City:AMSTERDAM
Mailing Address - State:NY
Mailing Address - Zip Code:12010-5716
Mailing Address - Country:US
Mailing Address - Phone:518-225-3252
Mailing Address - Fax:
Practice Address - Street 1:10B MADISON AVENUE EXT
Practice Address - Street 2:
Practice Address - City:ALBANY
Practice Address - State:NY
Practice Address - Zip Code:12203-7314
Practice Address - Country:US
Practice Address - Phone:518-867-3061
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-12-27
Last Update Date:2019-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant