Individual
CHRISTINE DIVIRGILIO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
711 TROY SCHENECTADY RD STE 216, LATHAM, NY 12110-2461
(518) 786-1665
Mailing address
711 TROY SCHENECTADY RD STE 209, LATHAM, NY 12110-2481
(518) 786-1667
(518) 786-1954
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
052064
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
07888324
—
NY
Enumeration date
08/07/2023
Last updated
07/23/2024
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