Provider Demographics
NPI:1871770958
Name:CONIGLIO, COLLENE LOUISE MERLINO (ATC)
Entity type:Individual
Prefix:MISS
First Name:COLLENE
Middle Name:LOUISE MERLINO
Last Name:CONIGLIO
Suffix:
Gender:F
Credentials:ATC
Other - Prefix:
Other - First Name:COLLENE
Other - Middle Name:LOUISE
Other - Last Name:MERLINO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:ATC
Mailing Address - Street 1:2540 SHERIDAN DR
Mailing Address - Street 2:
Mailing Address - City:TONAWANDA
Mailing Address - State:NY
Mailing Address - Zip Code:14150-9410
Mailing Address - Country:US
Mailing Address - Phone:716-862-0567
Mailing Address - Fax:716-862-0571
Practice Address - Street 1:2540 SHERIDAN DR
Practice Address - Street 2:
Practice Address - City:TONAWANDA
Practice Address - State:NY
Practice Address - Zip Code:14150-9410
Practice Address - Country:US
Practice Address - Phone:716-862-0567
Practice Address - Fax:716-862-0571
Is Sole Proprietor?:No
Enumeration Date:2008-01-30
Last Update Date:2013-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY001607-12255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer