Provider Demographics
NPI:1831320464
Name:PERRY, NANCY I (MT-BC, LCAT)
Entity Type:Individual
Prefix:MISS
First Name:NANCY
Middle Name:I
Last Name:PERRY
Suffix:
Gender:F
Credentials:MT-BC, LCAT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 10476
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14610-0476
Mailing Address - Country:US
Mailing Address - Phone:585-755-6165
Mailing Address - Fax:
Practice Address - Street 1:41 COLEBROOK DR
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14617-2211
Practice Address - Country:US
Practice Address - Phone:585-467-4567
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-30
Last Update Date:2009-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY07870225A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225A00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMusic Therapist