Provider Demographics
NPI:1518995406
Name:MILANESE, GRETCHEN L (PT)
Entity Type:Individual
Prefix:MRS
First Name:GRETCHEN
Middle Name:L
Last Name:MILANESE
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:8 CENTURY HILL DR
Mailing Address - Street 2:STE 201
Mailing Address - City:LATHAM
Mailing Address - State:NY
Mailing Address - Zip Code:12110-2193
Mailing Address - Country:US
Mailing Address - Phone:518-690-4406
Mailing Address - Fax:518-220-9220
Practice Address - Street 1:2 EMPIRE DR
Practice Address - Street 2:
Practice Address - City:RENSSELAER
Practice Address - State:NY
Practice Address - Zip Code:12144-5730
Practice Address - Country:US
Practice Address - Phone:518-268-4800
Practice Address - Fax:518-268-4888
Is Sole Proprietor?:No
Enumeration Date:2006-06-29
Last Update Date:2016-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY019002225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist