Healthcare Provider Details

I. General information

NPI: 1083769178
Provider Name (Legal Business Name): BARBARA MARIE BELLAMY P.T., D.P.T.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: BARBARA MARIE VAN SLYKE P.T.

II. Dates (important events)

Enumeration Date: 01/25/2007
Last Update Date: 01/20/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3 WEST AVE
LE ROY NY
14482-1367
US

IV. Provider business mailing address

5544 MAIN ST.
WILLIAMSVILLE NY
19221
US

V. Phone/Fax

Practice location:
  • Phone: 585-768-4550
  • Fax: 585-768-2335
Mailing address:
  • Phone: 716-580-3976
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number022968-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: