Provider Demographics
NPI:1740405455
Name:GILIBERTO, MARJORIE (PT, RN)
Entity Type:Individual
Prefix:MS
First Name:MARJORIE
Middle Name:
Last Name:GILIBERTO
Suffix:
Gender:F
Credentials:PT, RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:893 FLORENCE RD
Mailing Address - Street 2:
Mailing Address - City:FLORENCE
Mailing Address - State:MA
Mailing Address - Zip Code:01062-3667
Mailing Address - Country:US
Mailing Address - Phone:413-586-6399
Mailing Address - Fax:
Practice Address - Street 1:96 N PLEASANT ST
Practice Address - Street 2:SUITE 201
Practice Address - City:AMHERST
Practice Address - State:MA
Practice Address - Zip Code:01002-1717
Practice Address - Country:US
Practice Address - Phone:413-256-1922
Practice Address - Fax:413-256-1995
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA13293225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist