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General NPI Number Information
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NPI Number | 1932903994
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Entity Type | Individual
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Provider Name | TREASURE BLACKMAN
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Gender | Female
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Dates
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Enumeration Date | 04/01/2025
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Last Update Date | 04/01/2025
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Provider Practice Location Address
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Address Line | 4901 LAC DE VILLE BLVD STE 250
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City | ROCHESTER
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State | NY
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Zip | 14618-5649
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Country | US
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Telephone | 585-557-3868
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Fax |
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Provider Business Mailing Address
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Address Line | 66 BATTLE GREEN DR
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City | ROCHESTER
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State | NY
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Zip | 14624-4952
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Country | US
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Telephone | 585-743-9147
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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 | 053993
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License Number State | NY
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