Provider Demographics
NPI:1962491977
Name:LAMARCO, JONNA A (PT)
Entity Type:Individual
Prefix:
First Name:JONNA
Middle Name:A
Last Name:LAMARCO
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:JONNA
Other - Middle Name:L
Other - Last Name:AIELLO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:679 STARK TER
Mailing Address - Street 2:
Mailing Address - City:BALLSTON SPA
Mailing Address - State:NY
Mailing Address - Zip Code:12020-3073
Mailing Address - Country:US
Mailing Address - Phone:518-588-9434
Mailing Address - Fax:518-587-2567
Practice Address - Street 1:679 STARK TER
Practice Address - Street 2:
Practice Address - City:BALLSTON SPA
Practice Address - State:NY
Practice Address - Zip Code:12020-3073
Practice Address - Country:US
Practice Address - Phone:518-588-9434
Practice Address - Fax:518-587-2567
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-21
Last Update Date:2014-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY1099729Medicaid
NY1099729Medicaid