Individual
MRS. GAIL LUCILLE NISTICO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHYSICAL THERAPY ASS
Contact information
Practice address
256 SUNSET LAKE RD, SULLIVAN COUNTY ADULT CARE CENTER, LIBERTY, NY 12754
(845) 292-5910
Mailing address
219 SEMINARY RD., CALLICOON, NY 12723-5316
(845) 887-1956
(845) 887-1956
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
000169-1
NY
Other
Enumeration date
04/08/2010
Last updated
04/08/2010
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