Provider Demographics
NPI:1760759328
Name:NUWER, LISA A (PT,CHT)
Entity Type:Individual
Prefix:
First Name:LISA
Middle Name:A
Last Name:NUWER
Suffix:
Gender:F
Credentials:PT,CHT
Other - Prefix:
Other - First Name:LISA
Other - Middle Name:A
Other - Last Name:NUWER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:5144 SHERIDAN DR
Mailing Address - Street 2:
Mailing Address - City:WILLIAMSVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:14221-4648
Mailing Address - Country:US
Mailing Address - Phone:716-631-5224
Mailing Address - Fax:716-631-5626
Practice Address - Street 1:5144 SHERIDAN DR
Practice Address - Street 2:
Practice Address - City:WILLIAMSVILLE
Practice Address - State:NY
Practice Address - Zip Code:14221-4648
Practice Address - Country:US
Practice Address - Phone:716-631-5224
Practice Address - Fax:716-631-5626
Is Sole Proprietor?:No
Enumeration Date:2011-11-28
Last Update Date:2012-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY010898225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist