Provider Demographics
NPI:1407693195
Name:VELLEGGIA, GABRIELLA (DPT)
Entity type:Individual
Prefix:
First Name:GABRIELLA
Middle Name:
Last Name:VELLEGGIA
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21 TIMBERSHED CT
Mailing Address - Street 2:
Mailing Address - City:FREELAND
Mailing Address - State:MD
Mailing Address - Zip Code:21053-9789
Mailing Address - Country:US
Mailing Address - Phone:443-547-5126
Mailing Address - Fax:
Practice Address - Street 1:2240 GREENSPRING DR
Practice Address - Street 2:
Practice Address - City:TIMONIUM
Practice Address - State:MD
Practice Address - Zip Code:21093-3114
Practice Address - Country:US
Practice Address - Phone:667-401-0538
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-07-10
Last Update Date:2024-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD29958225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist