Michael Mark Militello, ATC
Specialist in Brockport, NY. Individual provider (NPI-1).
NPI number1629136809
StatusActive
Last updated in NPPESJul 8, 2007
Details
- NPI
- 1629136809
- Entity type
- Individual (NPI-1)
- Name
- Mr. Michael Mark Militello
- Credential
- ATC
- Sex
- Male
- Sole proprietor
- Yes
- Enumeration date
- Dec 4, 2006
- Last updated
- Jul 8, 2007
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 174400000X | Specialist | 000079 | NY | Yes |
Practice location
350 New Campus DrBrockport, NY 14420-2997
Phone 585-395-5355
Mailing address
50 Morning Glory LnRochester, NY 14626-4729
Phone 585-395-5355
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