Individual
DR. GIZELDA TARDIN BONAMICHI CASELLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D. PH.D.
Contact information
Practice address
750 E ADAMS ST, SYRACUSE, NY 13210-2306
(315) 464-8200
(315) 464-8201
Mailing address
750 E ADAMS ST, SYRACUSE, NY 13210-2306
(315) 464-8200
(315) 464-8201
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
276120
NY
2081P0004X
Spinal Cord Injury Medicine Physician
Primary
276120
NY
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03914481
—
NY
Enumeration date
04/13/2009
Last updated
09/26/2018
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