Provider Demographics
NPI:1659685303
Name:MIGLIOZZI, VANESSA NOELL (MS OTR/L)
Entity Type:Individual
Prefix:MRS
First Name:VANESSA
Middle Name:NOELL
Last Name:MIGLIOZZI
Suffix:
Gender:F
Credentials:MS OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:66 HULSE RD
Mailing Address - Street 2:
Mailing Address - City:EAST SETAUKET
Mailing Address - State:NY
Mailing Address - Zip Code:11733-3738
Mailing Address - Country:US
Mailing Address - Phone:631-834-2423
Mailing Address - Fax:
Practice Address - Street 1:66 HULSE RD
Practice Address - Street 2:
Practice Address - City:EAST SETAUKET
Practice Address - State:NY
Practice Address - Zip Code:11733-3738
Practice Address - Country:US
Practice Address - Phone:631-834-2423
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-04
Last Update Date:2012-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY017395-1225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist