Healthcare Provider Details

I. General information

NPI: 1164671087
Provider Name (Legal Business Name): HELEN TAYLOR PINE PT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: HELEN MARIA TAYLOR

II. Dates (important events)

Enumeration Date: 09/16/2008
Last Update Date: 11/28/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10714 NORTH RD
PERRYSBURG NY
14129-9746
US

IV. Provider business mailing address

1200 E AND WEST RD
WEST SENECA NY
14224-3604
US

V. Phone/Fax

Practice location:
  • Phone: 716-532-1049
  • Fax: 716-532-0679
Mailing address:
  • Phone: 716-608-9701
  • Fax: 716-608-0648

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number013587-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: