Provider Demographics
NPI:1659658763
Name:AIELLO, GINA (MPT)
Entity Type:Individual
Prefix:MS
First Name:GINA
Middle Name:
Last Name:AIELLO
Suffix:
Gender:F
Credentials:MPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:475 MAIN STREET
Mailing Address - Street 2:
Mailing Address - City:ARMONK
Mailing Address - State:NY
Mailing Address - Zip Code:10504-1840
Mailing Address - Country:US
Mailing Address - Phone:914-273-0800
Mailing Address - Fax:914-273-9287
Practice Address - Street 1:475 MAIN STREET
Practice Address - Street 2:
Practice Address - City:ARMONK
Practice Address - State:NY
Practice Address - Zip Code:10504-1840
Practice Address - Country:US
Practice Address - Phone:914-273-0800
Practice Address - Fax:914-273-9287
Is Sole Proprietor?:No
Enumeration Date:2011-11-03
Last Update Date:2011-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY025293-12251X0800X
CT0070592251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic