Provider Demographics
NPI:1548744865
Name:BASSIGNANI, MICHELLE K
Entity Type:Individual
Prefix:
First Name:MICHELLE
Middle Name:K
Last Name:BASSIGNANI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:490 MAIN ST APT 4
Mailing Address - Street 2:
Mailing Address - City:BEACON
Mailing Address - State:NY
Mailing Address - Zip Code:12508-3374
Mailing Address - Country:US
Mailing Address - Phone:845-242-4512
Mailing Address - Fax:
Practice Address - Street 1:490 MAIN ST APT 4
Practice Address - Street 2:
Practice Address - City:BEACON
Practice Address - State:NY
Practice Address - Zip Code:12508-3374
Practice Address - Country:US
Practice Address - Phone:845-242-4512
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-09-21
Last Update Date:2018-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist