Provider Demographics
NPI:1851542054
Name:FAMIGLETTI, ROSEMARIE (PT)
Entity Type:Individual
Prefix:MISS
First Name:ROSEMARIE
Middle Name:
Last Name:FAMIGLETTI
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3 HIGHLAND VIEW DR
Mailing Address - Street 2:
Mailing Address - City:BAYVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:11709-1807
Mailing Address - Country:US
Mailing Address - Phone:516-380-2941
Mailing Address - Fax:
Practice Address - Street 1:3 HIGHLAND VIEW DR
Practice Address - Street 2:
Practice Address - City:BAYVILLE
Practice Address - State:NY
Practice Address - Zip Code:11709-1807
Practice Address - Country:US
Practice Address - Phone:516-380-2941
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-06
Last Update Date:2008-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY024363-1225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist