Provider Demographics
NPI:1184694887
Name:MANN, PATRICIA (PT DPT)
Entity type:Individual
Prefix:
First Name:PATRICIA
Middle Name:
Last Name:MANN
Suffix:
Gender:F
Credentials:PT DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2333 N MAIN ST
Mailing Address - Street 2:PO BOX 412
Mailing Address - City:WARSAW
Mailing Address - State:NY
Mailing Address - Zip Code:14569
Mailing Address - Country:US
Mailing Address - Phone:585-786-8700
Mailing Address - Fax:585-786-2659
Practice Address - Street 1:120 PROSPECT ST
Practice Address - Street 2:STEP BY STEP PHYSICAL THERAPY
Practice Address - City:ATTICA
Practice Address - State:NY
Practice Address - Zip Code:14011
Practice Address - Country:US
Practice Address - Phone:585-591-3082
Practice Address - Fax:585-591-3084
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-01-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY020427225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY000626890001OtherBCBS OF WESTERN NEW YORK
NY02271429Medicaid
P62467Medicare UPIN
NY02271429Medicaid