Provider Demographics
NPI:1669821260
Name:CIAMMAICHELLA, ELLIA (DO)
Entity type:Individual
Prefix:
First Name:ELLIA
Middle Name:
Last Name:CIAMMAICHELLA
Suffix:
Gender:
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5150 MAE ANNE AVE STE 405
Mailing Address - Street 2:
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89523-1859
Mailing Address - Country:US
Mailing Address - Phone:775-902-6917
Mailing Address - Fax:
Practice Address - Street 1:5150 MAE ANNE AVE STE 405
Practice Address - Street 2:
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89523-1859
Practice Address - Country:US
Practice Address - Phone:408-857-3395
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-06-06
Last Update Date:2025-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAOP61074874208100000X, 2081P0301X
MTMED-PHYS-COM-LIC-117208100000X
AK200818208100000X, 2081P0301X, 2081P0301X
UT11273456-1204208100000X, 2081P0301X
IDO-1775208100000X, 2081P0301X
CA22251208100000X
NVDO2977208100000X, 2081P0004X, 2081P0301X
COCDR.0004654208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
No2081P0004XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationSpinal Cord Injury Medicine
No2081P0301XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationBrain Injury Medicine