Provider Demographics
NPI:1679121032
Name:GULITTI, EMILY ROSE
Entity Type:Individual
Prefix:
First Name:EMILY
Middle Name:ROSE
Last Name:GULITTI
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 1:24 JEFFERY DR
Mailing Address - Street 2:
Mailing Address - City:TILLSON
Mailing Address - State:NY
Mailing Address - Zip Code:12486-1005
Mailing Address - Country:US
Mailing Address - Phone:845-802-1344
Mailing Address - Fax:
Practice Address - Street 1:24 JEFFERY DR
Practice Address - Street 2:
Practice Address - City:TILLSON
Practice Address - State:NY
Practice Address - Zip Code:12486-1005
Practice Address - Country:US
Practice Address - Phone:845-802-1344
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-08-29
Last Update Date:2021-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer