Provider Demographics
NPI:1083769178
Name:BELLAMY, BARBARA MARIE (PT, DPT)
Entity Type:Individual
Prefix:MRS
First Name:BARBARA
Middle Name:MARIE
Last Name:BELLAMY
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:BARBARA
Other - Middle Name:MARIE
Other - Last Name:VAN SLYKE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:5544 MAIN ST.
Mailing Address - Street 2:
Mailing Address - City:WILLIAMSVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:19221
Mailing Address - Country:US
Mailing Address - Phone:716-580-3976
Mailing Address - Fax:
Practice Address - Street 1:3 WEST AVE
Practice Address - Street 2:
Practice Address - City:LE ROY
Practice Address - State:NY
Practice Address - Zip Code:14482-1367
Practice Address - Country:US
Practice Address - Phone:585-768-4550
Practice Address - Fax:585-768-2335
Is Sole Proprietor?:No
Enumeration Date:2007-01-25
Last Update Date:2017-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY022968-1225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY11690024OtherCAQH