=====================================================
General NPI Number Information
=====================================================
NPI Number | 1487896098
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | PATRICIA D REFERMAT R.N.,LMT
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 03/27/2009
-----------------------------------------------------
Last Update Date | 03/27/2009
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 38 LAKE ST
-----------------------------------------------------
City | HAMBURG
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 14075-4908
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 716-649-9004
-----------------------------------------------------
Fax | 866-352-0284
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 38 LAKE ST
-----------------------------------------------------
City | HAMBURG
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 14075-4908
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 716-649-9004
-----------------------------------------------------
Fax | 866-352-0284
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 163WM1400X
-----------------------------------------------------
Taxonomy Name | Nurse Massage Therapist (NMT)
-----------------------------------------------------
License Number | 020530-1
-----------------------------------------------------
License Number State | NY
-----------------------------------------------------