Provider Demographics
NPI:1558035832
Name:MAY, LEAH (PT, DPT)
Entity Type:Individual
Prefix:
First Name:LEAH
Middle Name:
Last Name:MAY
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 1:2450 MAPLE AVE
Mailing Address - Street 2:
Mailing Address - City:PALMYRA
Mailing Address - State:NY
Mailing Address - Zip Code:14522-9372
Mailing Address - Country:US
Mailing Address - Phone:585-309-5343
Mailing Address - Fax:
Practice Address - Street 1:5205 OAKWOOD DR
Practice Address - Street 2:
Practice Address - City:NORTH TONAWANDA
Practice Address - State:NY
Practice Address - Zip Code:14120-9618
Practice Address - Country:US
Practice Address - Phone:716-432-6268
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-08-02
Last Update Date:2021-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC9873225100000X
NY044695225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist