Provider Demographics
NPI:1730513599
Name:PEROTTI, MELISSA ASHLEIGH (PT, DPT)
Entity type:Individual
Prefix:
First Name:MELISSA
Middle Name:ASHLEIGH
Last Name:PEROTTI
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:MELISSA
Other - Middle Name:ASHLEIGH
Other - Last Name:PEROTTI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT, DPT
Mailing Address - Street 1:PO BOX 367
Mailing Address - Street 2:
Mailing Address - City:COHOES
Mailing Address - State:NY
Mailing Address - Zip Code:12047-0367
Mailing Address - Country:US
Mailing Address - Phone:860-248-1233
Mailing Address - Fax:
Practice Address - Street 1:81 MOHAWK ST
Practice Address - Street 2:
Practice Address - City:COHOES
Practice Address - State:NY
Practice Address - Zip Code:12047-2809
Practice Address - Country:US
Practice Address - Phone:518-235-2329
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-08-29
Last Update Date:2015-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY036823-1225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist