Provider Demographics
NPI:1801417894
Name:SEVEY, MARY A (PT)
Entity Type:Individual
Prefix:
First Name:MARY
Middle Name:A
Last Name:SEVEY
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:MARY
Other - Middle Name:A
Other - Last Name:ABBEY
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PT
Mailing Address - Street 1:2017 KIM DR
Mailing Address - Street 2:
Mailing Address - City:ENDICOTT
Mailing Address - State:NY
Mailing Address - Zip Code:13760-1416
Mailing Address - Country:US
Mailing Address - Phone:607-759-2180
Mailing Address - Fax:
Practice Address - Street 1:4102 VESTAL RD
Practice Address - Street 2:
Practice Address - City:VESTAL
Practice Address - State:NY
Practice Address - Zip Code:13850-3531
Practice Address - Country:US
Practice Address - Phone:607-772-1598
Practice Address - Fax:607-771-0669
Is Sole Proprietor?:No
Enumeration Date:2020-04-30
Last Update Date:2020-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY008010225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist