Provider Demographics
NPI:1417155052
Name:WERTH, MARY SHARON (PT, DPT)
Entity Type:Individual
Prefix:DR
First Name:MARY
Middle Name:SHARON
Last Name:WERTH
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11 OAK ST
Mailing Address - Street 2:UPPER APARTMENT
Mailing Address - City:SILVER CREEK
Mailing Address - State:NY
Mailing Address - Zip Code:14136-1217
Mailing Address - Country:US
Mailing Address - Phone:585-943-7083
Mailing Address - Fax:
Practice Address - Street 1:8505 ERIE RD
Practice Address - Street 2:
Practice Address - City:ANGOLA
Practice Address - State:NY
Practice Address - Zip Code:14006-9703
Practice Address - Country:US
Practice Address - Phone:716-549-1099
Practice Address - Fax:716-549-2293
Is Sole Proprietor?:No
Enumeration Date:2007-07-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY027386-1225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist