MEDICARE: MS. BEVERLY AMBORSKI LMT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	172M00000X	Mechanotherapist	024088	NY

General Provider Information

NPI Number	:	1063701506
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. BEVERLY AMBORSKI LMT

Provider Business Mailing Address
First Line	:	4477 ARONDALE DR
Second Line	:
City	:	WILLIAMSVILLE
State	:	NY
Zip	:	14221-6222
Country	:	US
Telephone Number	:	716-634-1218
Fax Number	:

Provider Business Practice Location Address
First Line	:	9146 MAIN ST
Second Line	:
City	:	CLARENCE
State	:	NY
Zip	:	14031-1929
Country	:	US
Telephone Number	:	716-939-0365
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/05/2011
Last Update Date	:	04/05/2011

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