=====================================================
General NPI Number Information
=====================================================
NPI Number | 1104027259
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | NORTH FRENCH PHYSICAL THERAPY LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 05/29/2007
-----------------------------------------------------
Last Update Date | 08/22/2020
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 646 N FRENCH RD SUITE 5
-----------------------------------------------------
City | AMHERST
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 14228-2100
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 716-564-0922
-----------------------------------------------------
Fax | 716-564-0921
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 646 N FRENCH RD SUITE 5
-----------------------------------------------------
City | AMHERST
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 14228-2100
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 716-564-0922
-----------------------------------------------------
Fax | 716-564-0921
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | MRS. RENU VERMA
-----------------------------------------------------
Credential | PT
-----------------------------------------------------
Telephone | 716-564-0922
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 2251C2600X
-----------------------------------------------------
Taxonomy Name | Cardiopulmonary Physical Therapist
-----------------------------------------------------
License Number | 020375-1
-----------------------------------------------------
License Number State | NY
-----------------------------------------------------