Provider Demographics
NPI:1013228576
Name:ATEN, NANCY (PT)
Entity Type:Individual
Prefix:MRS
First Name:NANCY
Middle Name:
Last Name:ATEN
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18278 N HARBOR RD
Mailing Address - Street 2:
Mailing Address - City:ADAMS CENTER
Mailing Address - State:NY
Mailing Address - Zip Code:13606-2100
Mailing Address - Country:US
Mailing Address - Phone:315-583-5110
Mailing Address - Fax:
Practice Address - Street 1:21638 REED RD
Practice Address - Street 2:
Practice Address - City:WATERTOWN
Practice Address - State:NY
Practice Address - Zip Code:13601-5048
Practice Address - Country:US
Practice Address - Phone:315-786-0677
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-06-29
Last Update Date:2010-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY004983-12251P0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatrics