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NPI 1134925415

NPI 1134925415 : JUSTIN VARNEY PT, DPT : GRAND ISLAND, NY

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General NPI Number Information
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    NPI Number           |    1134925415
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    Entity Type          |    Individual 
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    Provider Name        |    JUSTIN VARNEY PT, DPT
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    02/19/2025
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    Last Update Date     |    02/19/2025
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Provider Practice Location Address
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    Address Line         |    1801 GRAND ISLAND BLVD 
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    City                 |    GRAND ISLAND
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    State                |    NY
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    Zip                  |    14072-2249
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    Country              |    US
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    Telephone            |    716-773-4323
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    50 SPRUCE ST APT 2 
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    City                 |    LOCKPORT
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    State                |    NY
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    Zip                  |    14094-4987
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    Country              |    US
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    Telephone            |    585-764-5794
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    Fax                  |    
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Authorized Official
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    Title or Position    |    
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    Name                 |        
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    Credential           |    
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    Telephone            |    
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    225100000X
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    Taxonomy Name        |    Physical Therapist
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    License Number       |    053843
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    License Number State |    NY
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