Provider Demographics
NPI:1992853006
Name:GIGLIO, JOSEPH (DPT)
Entity Type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:
Last Name:GIGLIO
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8 CANVASBACK LN
Mailing Address - Street 2:
Mailing Address - City:EAST QUOGUE
Mailing Address - State:NY
Mailing Address - Zip Code:11942-4825
Mailing Address - Country:US
Mailing Address - Phone:631-594-2191
Mailing Address - Fax:631-594-2191
Practice Address - Street 1:8 CANVASBACK LN
Practice Address - Street 2:
Practice Address - City:EAST QUOGUE
Practice Address - State:NY
Practice Address - Zip Code:11942-4825
Practice Address - Country:US
Practice Address - Phone:631-594-2191
Practice Address - Fax:631-594-2191
Is Sole Proprietor?:No
Enumeration Date:2007-01-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY010858225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYQ43061Medicare ID - Type Unspecified