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NPI Code Detail

MEDICARE: NATHAN JAY HUNGATE MPT

MEDICARE:   NATHAN JAY HUNGATE  MPT
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
1225100000XPhysical Therapist030469NY

General Provider Information

NPI Number : 1184880551
Entity Type Code : Individual
Provider Name (Legal Business Name) : NATHAN JAY HUNGATE MPT
Provider Business Mailing Address
First Line : 92 WEST AVE
Second Line :
City : BROCKPORT
State : NY
Zip : 14420-1306
Country : US
Telephone Number : 585-637-0790
Fax Number : 585-637-3572
Provider Business Practice Location Address
First Line : 92 WEST AVE
Second Line :
City : BROCKPORT
State : NY
Zip : 14420-1306
Country : US
Telephone Number : 585-637-0790
Fax Number : 585-637-3572
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/05/2008
Last Update Date : 08/05/2008

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Directions to “ NATHAN JAY HUNGATE MPT” Practice Location

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