National Provider Identifier
Jala Nicole Gilliam, DPT, PT
Jala Nicole Gilliam, DPT, PT is listed in the NPPES registry with a primary specialty of Physical Therapist in Buffalo, NY and a listed phone number of (716) 342-1100.
Source: public NPPES record, last updated October 01, 2022. This profile is informational and is not medical advice, a quality rating, or a provider recommendation.
Profile Overview
- NPI
- 1710606694
- Provider Type
- Individual
- Primary Specialty
- Physical Therapist
- Enumeration Date
- August 24, 2022
- Last Updated
- October 01, 2022
Practice Location
- 2633 Main St
- Buffalo, NY 14214-2096
Phone: (716) 342-1100
Specialties
- Physical Therapist (225100000X)
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Full Record
- NPI
- 1710606694
- Entity Type
- Individual
- Last Name
- Gilliam
- First Name
- Jala
- Middle Name
- Nicole
- Credential
- DPT, PT
- Mailing Street Address
- 2633 Main St
- Mailing City
- Buffalo
- Mailing State
- NY
- Mailing ZIP Code
- 14214-2096
- Mailing Country
- US
- Mailing Phone
- (716) 342-1100
- Practice Street Address
- 2633 Main St
- Practice City
- Buffalo
- Practice State
- NY
- Practice ZIP Code
- 14214-2096
- Practice Country
- US
- Practice Phone
- (716) 342-1100
- Enumeration Date
- August 24, 2022
- Last Updated
- October 01, 2022
- Sex
- Female
- Sole Proprietor
- No
- Certification Date
- October 01, 2022
- Taxonomies
- Physical Therapist (225100000X)
- Other Identifiers
- 049102 (NY, Nys License)