Provider Demographics
NPI:1447621370
Name:GIAMMELLA, ELAINE BETH (LPN)
Entity type:Individual
Prefix:
First Name:ELAINE
Middle Name:BETH
Last Name:GIAMMELLA
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:627 CABLE RD
Mailing Address - Street 2:
Mailing Address - City:WILLIAMSTOWN
Mailing Address - State:NY
Mailing Address - Zip Code:13493-1916
Mailing Address - Country:US
Mailing Address - Phone:315-751-5613
Mailing Address - Fax:
Practice Address - Street 1:627 CABLE RD
Practice Address - Street 2:
Practice Address - City:WILLIAMSTOWN
Practice Address - State:NY
Practice Address - Zip Code:13493-1916
Practice Address - Country:US
Practice Address - Phone:315-751-5613
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-10-19
Last Update Date:2015-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY2311321164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse