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NPI Code Detail

MEDICARE: PEDIATRIC PHYSICAL THERAPY SERVICES, PLLC

MEDICARE: PEDIATRIC PHYSICAL THERAPY SERVICES, PLLC
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 Therapist

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1G0189088590OTHERBLUE CHOICE
260002OTHERBLUE CROSS BLUE SHIELD

General Provider Information

NPI Number : 1861534281
Entity Type Code : Organization
Provider Name (Legal Business Name) : PEDIATRIC PHYSICAL THERAPY SERVICES, PLLC
Provider Business Mailing Address
First Line : 3255 BRIGHTON HENRIETTA TOWN LINE RD
Second Line : SUITE 102
City : ROCHESTER
State : NY
Zip : 14623-2806
Country : US
Telephone Number : 585-427-7610
Fax Number : 585-427-7410
Provider Business Practice Location Address
First Line : 3255 BRIGHTON HENRIETTA TOWN LINE RD
Second Line : SUITE 102
City : ROCHESTER
State : NY
Zip : 14623-2806
Country : US
Telephone Number : 585-427-7610
Fax Number : 585-427-7410
Authorized Official
Title or Position : OWNER
Name : PIA L. STAMPE
Credential : P.T.
Telephone Number : 585-427-7610
Provider Enumeration Date : 02/13/2007
Last Update Date : 10/02/2008

Similar Medicare Providers

1326204876 — MICHELLE FRENCH
Practice Location Address:
3255 BRIGHTON HENRIETTA TOWN LINE RD , SUITE 102
ROCHESTER, NY
14623-2806
Practice Phone: 585-427-7610
Practice Fax:
1457599748 — ASHLEY BESS WILLIAMS PT, DPT
Practice Location Address:
3255 BRIGHTON HENRIETTA TOWN LINE RD , SUITE 102
ROCHESTER, NY
14623-2806
Practice Phone: 585-427-7610
Practice Fax: 585-427-7410
1265670475 — KELLY ELEANOR O'MARA PT, DPT
Practice Location Address:
3255 BRIGHTON HENRIETTA TOWN LINE RD , SUITE 102
ROCHESTER, NY
14623-2806
Practice Phone: 585-427-7610
Practice Fax: 585-427-7410
1760798987 — APRYL N AMO JACKSON
Practice Location Address:
3255 BRIGHTON HENRIETTA TOWN LINE RD , SUITE 102
ROCHESTER, NY
14623-2806
Practice Phone: 585-427-7610
Practice Fax: 585-427-7410
1124306394 — SHANNON M BOLGER PT, DPT
Practice Location Address:
3255 BRIGHTON HENRIETTA TOWN LINE RD , SUITE 102
ROCHESTER, NY
14623-2806
Practice Phone: 585-427-2977
Practice Fax:
1477815611 — LAURA KRAGER HURWITZ
Practice Location Address:
3255 BRIGHTON HENRIETTA TL RD
ROCHESTER, NY
14623-2806
Practice Phone: 585-427-2977
Practice Fax:

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