Provider Demographics
NPI:1124227616
Name:LAWNEY, GINA NICOLE (DPT)
Entity Type:Individual
Prefix:DR
First Name:GINA
Middle Name:NICOLE
Last Name:LAWNEY
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 504
Mailing Address - Street 2:5 ST. MARKS PLACE
Mailing Address - City:FORT MONTGOMERY
Mailing Address - State:NY
Mailing Address - Zip Code:10922-0054
Mailing Address - Country:US
Mailing Address - Phone:845-859-4110
Mailing Address - Fax:845-335-5631
Practice Address - Street 1:5 ST. MARKS PLACE
Practice Address - Street 2:
Practice Address - City:FORT MONTGOMERY
Practice Address - State:NY
Practice Address - Zip Code:10922-0054
Practice Address - Country:US
Practice Address - Phone:845-859-4110
Practice Address - Fax:845-335-5631
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-13
Last Update Date:2018-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY020325225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist