Provider Demographics
NPI:1720354566
Name:DOMOY, MELISSA BIGGER (PT)
Entity Type:Individual
Prefix:MRS
First Name:MELISSA
Middle Name:BIGGER
Last Name:DOMOY
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 1:5174 EDWARDS RD
Mailing Address - Street 2:
Mailing Address - City:MEDINA
Mailing Address - State:NY
Mailing Address - Zip Code:14103-9771
Mailing Address - Country:US
Mailing Address - Phone:203-313-5841
Mailing Address - Fax:
Practice Address - Street 1:5174 EDWARDS RD
Practice Address - Street 2:
Practice Address - City:MEDINA
Practice Address - State:NY
Practice Address - Zip Code:14103-9771
Practice Address - Country:US
Practice Address - Phone:203-313-5841
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-03-27
Last Update Date:2012-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY019103-1225100000X
CT007921225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist