Provider Demographics
NPI:1689842866
Name:AGGELOU, AMY ELISABETH (ATC)
Entity Type:Individual
Prefix:
First Name:AMY
Middle Name:ELISABETH
Last Name:AGGELOU
Suffix:
Gender:F
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:142 BROOKMEADE DR
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15237-1764
Mailing Address - Country:US
Mailing Address - Phone:412-548-3108
Mailing Address - Fax:
Practice Address - Street 1:5062 FORBES TOWER
Practice Address - Street 2:SCHOOL OF HEALTH AND REHABILITATION SCIENCES
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15260
Practice Address - Country:US
Practice Address - Phone:412-383-9738
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-02-11
Last Update Date:2008-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PART001896A2255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer