Provider Demographics
NPI:1881616373
Name:PANZARELLA, JOANNE (PT)
Entity type:Individual
Prefix:MS
First Name:JOANNE
Middle Name:
Last Name:PANZARELLA
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 1:101 SULLYS TRL
Mailing Address - Street 2:BLDG 20, SUITE 9
Mailing Address - City:PITTSFORD
Mailing Address - State:NY
Mailing Address - Zip Code:14534-4552
Mailing Address - Country:US
Mailing Address - Phone:585-248-0015
Mailing Address - Fax:585-248-0019
Practice Address - Street 1:101 SULLYS TRL
Practice Address - Street 2:BLDG 20, SUITE 9
Practice Address - City:PITTSFORD
Practice Address - State:NY
Practice Address - Zip Code:14534-4552
Practice Address - Country:US
Practice Address - Phone:585-248-0015
Practice Address - Fax:585-248-0019
Is Sole Proprietor?:No
Enumeration Date:2006-07-24
Last Update Date:2015-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0093111225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist