Provider Demographics
NPI:1073631255
Name:NYATSAMBO, PAMELA (MSPT)
Entity Type:Individual
Prefix:
First Name:PAMELA
Middle Name:
Last Name:NYATSAMBO
Suffix:
Gender:F
Credentials:MSPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:29 TOFTREE LN
Mailing Address - Street 2:
Mailing Address - City:DOVER
Mailing Address - State:NH
Mailing Address - Zip Code:03820-4657
Mailing Address - Country:US
Mailing Address - Phone:603-299-6707
Mailing Address - Fax:
Practice Address - Street 1:195 DOVER POINT RD
Practice Address - Street 2:
Practice Address - City:DOVER
Practice Address - State:NH
Practice Address - Zip Code:03820-4612
Practice Address - Country:US
Practice Address - Phone:603-742-2612
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH2646225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist