Provider Demographics
NPI:1558499178
Name:GOW, ANN TERESA (PT)
Entity Type:Individual
Prefix:MS
First Name:ANN
Middle Name:TERESA
Last Name:GOW
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 1:46 WINFIELD AVE
Mailing Address - Street 2:HARRISON
Mailing Address - City:HARRISON
Mailing Address - State:NY
Mailing Address - Zip Code:10528-2412
Mailing Address - Country:US
Mailing Address - Phone:914-525-5974
Mailing Address - Fax:914-777-1365
Practice Address - Street 1:46 WINFIELD AVENUE
Practice Address - Street 2:
Practice Address - City:HARRISON
Practice Address - State:NY
Practice Address - Zip Code:10528-2412
Practice Address - Country:US
Practice Address - Phone:914-525-5974
Practice Address - Fax:914-777-1365
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-02
Last Update Date:2008-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY012458225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYQ85581Medicare ID - Type Unspecified