Provider Demographics
NPI:1932475514
Name:GIAMMELLA, MICHELE (PT)
Entity Type:Individual
Prefix:
First Name:MICHELE
Middle Name:
Last Name:GIAMMELLA
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 1:26 CONKEY AVE
Mailing Address - Street 2:BOX 136
Mailing Address - City:NORWICH
Mailing Address - State:NY
Mailing Address - Zip Code:13815-1756
Mailing Address - Country:US
Mailing Address - Phone:607-334-5010
Mailing Address - Fax:607-336-7326
Practice Address - Street 1:26 CONKEY AVE
Practice Address - Street 2:UHS THERAPIES NORWICH
Practice Address - City:NORWICH
Practice Address - State:NY
Practice Address - Zip Code:13815-1756
Practice Address - Country:US
Practice Address - Phone:607-334-5010
Practice Address - Fax:607-336-7326
Is Sole Proprietor?:No
Enumeration Date:2012-03-28
Last Update Date:2013-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY015956-1225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist