Provider Demographics
NPI:1528039492
Name:GIAMPAGLIA, BENITO (PT,MTC)
Entity Type:Individual
Prefix:
First Name:BENITO
Middle Name:
Last Name:GIAMPAGLIA
Suffix:
Gender:M
Credentials:PT,MTC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1053 SAW MILL RIVER RD
Mailing Address - Street 2:SUITE105
Mailing Address - City:ARDSLEY
Mailing Address - State:NY
Mailing Address - Zip Code:10502-1048
Mailing Address - Country:US
Mailing Address - Phone:914-693-2350
Mailing Address - Fax:914-693-7661
Practice Address - Street 1:1053 SAW MILL RIVER RD
Practice Address - Street 2:SUITE105
Practice Address - City:ARDSLEY
Practice Address - State:NY
Practice Address - Zip Code:10502-1048
Practice Address - Country:US
Practice Address - Phone:914-693-2350
Practice Address - Fax:914-693-7661
Is Sole Proprietor?:No
Enumeration Date:2006-01-30
Last Update Date:2007-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY01217012251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYQQ810Q11S1Medicare PIN
NYQQ8101Medicare ID - Type Unspecified