Provider Demographics
NPI:1235272964
Name:STANG, NANCY L (PT)
Entity Type:Individual
Prefix:MISS
First Name:NANCY
Middle Name:L
Last Name:STANG
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 1:259 E TERRACE AVE
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:NY
Mailing Address - Zip Code:14750-1530
Mailing Address - Country:US
Mailing Address - Phone:716-665-8130
Mailing Address - Fax:716-720-9321
Practice Address - Street 1:715 FALCONER ST
Practice Address - Street 2:
Practice Address - City:JAMESTOWN
Practice Address - State:NY
Practice Address - Zip Code:14701-1935
Practice Address - Country:US
Practice Address - Phone:716-665-8130
Practice Address - Fax:716-720-9321
Is Sole Proprietor?:No
Enumeration Date:2007-02-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY007134-1225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist