Provider Demographics
NPI:1639447766
Name:PEARCE, NANCY E (PTA)
Entity Type:Individual
Prefix:MRS
First Name:NANCY
Middle Name:E
Last Name:PEARCE
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:MRS
Other - First Name:NANCY
Other - Middle Name:E
Other - Last Name:LEMKE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PTA
Mailing Address - Street 1:19 OLEAN ST
Mailing Address - Street 2:
Mailing Address - City:EAST AURORA
Mailing Address - State:NY
Mailing Address - Zip Code:14052
Mailing Address - Country:US
Mailing Address - Phone:716-652-3127
Mailing Address - Fax:716-652-3128
Practice Address - Street 1:19 OLEAN ST
Practice Address - Street 2:
Practice Address - City:EAST AURORA
Practice Address - State:NY
Practice Address - Zip Code:14052
Practice Address - Country:US
Practice Address - Phone:716-652-3127
Practice Address - Fax:716-652-3128
Is Sole Proprietor?:No
Enumeration Date:2011-12-04
Last Update Date:2017-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY005716-1225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant