Healthcare Provider Details

I. General information

NPI: 1558032094
Provider Name (Legal Business Name): ANDREW WARD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/24/2021
Last Update Date: 07/10/2025
Certification Date: 07/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

75 JONES AND GIFFORD AVE
JAMESTOWN NY
14701-2828
US

IV. Provider business mailing address

75 JONES AND GIFFORD AVE
JAMESTOWN NY
14701-2828
US

V. Phone/Fax

Practice location:
  • Phone: 716-661-1541
  • Fax:
Mailing address:
  • Phone: 716-661-1541
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number047432
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT7070
License Number StateME

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: