Provider Demographics
NPI:1942498944
Name:GREY, DEBORA M (LMT)
Entity Type:Individual
Prefix:MS
First Name:DEBORA
Middle Name:M
Last Name:GREY
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:3435 HARLEM RD
Mailing Address - Street 2:SUITE 7
Mailing Address - City:BUFFALO
Mailing Address - State:NY
Mailing Address - Zip Code:14225-2021
Mailing Address - Country:US
Mailing Address - Phone:716-479-8298
Mailing Address - Fax:716-836-1568
Practice Address - Street 1:3435 HARLEM RD
Practice Address - Street 2:SUITE 7
Practice Address - City:BUFFALO
Practice Address - State:NY
Practice Address - Zip Code:14225-2021
Practice Address - Country:US
Practice Address - Phone:716-479-8298
Practice Address - Fax:716-836-1568
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-04
Last Update Date:2007-10-04
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY11832225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist