Provider Demographics
NPI:1225313240
Name:STAMP, MICHELE ANNE (PT)
Entity Type:Individual
Prefix:MRS
First Name:MICHELE
Middle Name:ANNE
Last Name:STAMP
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 1:2A RICHMOND AVE
Mailing Address - Street 2:PHYSICAL THERAPY DEPARTMENT
Mailing Address - City:BATAVIA
Mailing Address - State:NY
Mailing Address - Zip Code:14020-1408
Mailing Address - Country:US
Mailing Address - Phone:585-343-5384
Mailing Address - Fax:
Practice Address - Street 1:2A RICHMOND AVE
Practice Address - Street 2:PHYSICAL THERAPY DEPARTMENT
Practice Address - City:BATAVIA
Practice Address - State:NY
Practice Address - Zip Code:14020-1408
Practice Address - Country:US
Practice Address - Phone:585-343-5384
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-10-21
Last Update Date:2011-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0106592251P0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatrics