Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225X00000X | Occupational Therapist |
NPI | 1003407305 |
---|---|
Provider Name | Nicole Giliforte |
First Address | Tonawanda, NY 14150-8520 |
Second Address | Kenmore, NY 14217-1040 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/01/2021 |
Last Update Date | 29/01/2021 |