National Provider Identifier
Melissa W Thibault, M.D.
Melissa W Thibault, M.D. is listed in the NPPES registry with a primary specialty of Physical Medicine & Rehabilitation Physician in Ithaca, NY and a listed phone number of (607) 277-4097.
Profile Overview
- NPI
- 1841283413
- Provider Type
- Individual
- Primary Specialty
- Physical Medicine & Rehabilitation Physician
- Enumeration Date
- August 29, 2005
- Last Updated
- November 13, 2008
Practice Location
- 201 Dates Dr
- Suite 201
- Ithaca, NY 14850-1345
Phone: (607) 277-4097
Mailing Address
- 202 Taughannock Blvd
- PO Box 366
- Ithaca, NY 14850-3328
Specialties
- Physical Medicine & Rehabilitation Physician (208100000X)
Full Record
- NPI
- 1841283413
- Entity Type
- Individual
- Last Name
- Thibault
- First Name
- Melissa
- Middle Name
- W
- Name Prefix
- Dr.
- Credential
- M.D.
- Mailing Street Address
- 202 Taughannock Blvd
- Mailing Address Line 2
- PO Box 366
- Mailing City
- Ithaca
- Mailing State
- NY
- Mailing ZIP Code
- 14850-3328
- Mailing Country
- US
- Mailing Phone
- (607) 277-3257
- Mailing Fax
- (607) 277-4056
- Practice Street Address
- 201 Dates Dr
- Practice Address Line 2
- Suite 201
- Practice City
- Ithaca
- Practice State
- NY
- Practice ZIP Code
- 14850-1345
- Practice Country
- US
- Practice Phone
- (607) 277-4097
- Practice Fax
- (607) 277-4142
- Enumeration Date
- August 29, 2005
- Last Updated
- November 13, 2008
- Sex
- Female
- Sole Proprietor
- No
- updated_by_file
- npidata_pfile_20050523-20260308.csv
- Taxonomies
- Physical Medicine & Rehabilitation Physician (208100000X)
- Other Identifiers
- 02552894 (NY)