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NPI Code Detail

MEDICARE: LAURA P NEVILLE MSPT

MEDICARE:   LAURA P NEVILLE  MSPT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225100000XPhysical Therapist022224-1NY

General Provider Information

NPI Number : 1528152410
Entity Type Code : Individual
Provider Name (Legal Business Name) : LAURA P NEVILLE MSPT
Provider Business Mailing Address
First Line : 1 ADLER DR
Second Line :
City : EAST SYRACUSE
State : NY
Zip : 13057-1223
Country : US
Telephone Number : 315-469-1189
Fax Number : 315-492-0548
Provider Business Practice Location Address
First Line : 1 ADLER DR
Second Line :
City : EAST SYRACUSE
State : NY
Zip : 13057-1223
Country : US
Telephone Number : 315-469-1189
Fax Number : 315-492-0548
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/03/2006
Last Update Date : 11/21/2008

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Directions to “ LAURA P NEVILLE MSPT” Practice Location

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