Healthcare Provider Details

I. General information

NPI: 1821395237
Provider Name (Legal Business Name): JOCELYN A SEAVEY-BARNES PTA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/21/2011
Last Update Date: 02/21/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

159 W 1ST ST
OSWEGO NY
13126-2045
US

IV. Provider business mailing address

11 MERRITT AVE
MASSENA NY
13662-2312
US

V. Phone/Fax

Practice location:
  • Phone: 315-342-9575
  • Fax: 315-342-7664
Mailing address:
  • Phone: 315-705-4474
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225200000X
TaxonomyPhysical Therapy Assistant
License Number4942
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: