Provider Demographics
NPI:1245847508
Name:FRANK, PAMELA (MT, PT)
Entity type:Individual
Prefix:
First Name:PAMELA
Middle Name:
Last Name:FRANK
Suffix:
Gender:F
Credentials:MT, PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3878 N MILLGROVE RD
Mailing Address - Street 2:
Mailing Address - City:ALDEN
Mailing Address - State:NY
Mailing Address - Zip Code:14004-9632
Mailing Address - Country:US
Mailing Address - Phone:716-316-5519
Mailing Address - Fax:
Practice Address - Street 1:8270 WEHRLE DR
Practice Address - Street 2:
Practice Address - City:WILLIAMSVILLE
Practice Address - State:NY
Practice Address - Zip Code:14221-7392
Practice Address - Country:US
Practice Address - Phone:716-634-6243
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-09-30
Last Update Date:2020-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY008928-1225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist