Provider Demographics
NPI:1043384001
Name:SPECHT, DEBORAH A (PT)
Entity Type:Individual
Prefix:
First Name:DEBORAH
Middle Name:A
Last Name:SPECHT
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 1:1370 EXCHANGE ST
Mailing Address - Street 2:
Mailing Address - City:ALDEN
Mailing Address - State:NY
Mailing Address - Zip Code:14004-1349
Mailing Address - Country:US
Mailing Address - Phone:716-937-3888
Mailing Address - Fax:716-937-3243
Practice Address - Street 1:1370 EXCHANGE ST
Practice Address - Street 2:
Practice Address - City:ALDEN
Practice Address - State:NY
Practice Address - Zip Code:14004-1349
Practice Address - Country:US
Practice Address - Phone:716-937-3888
Practice Address - Fax:716-937-3243
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY005579-1225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist