Provider Demographics
NPI:1265724538
Name:BARNEY, LAURIE CAMPBELL (PT)
Entity type:Individual
Prefix:
First Name:LAURIE
Middle Name:CAMPBELL
Last Name:BARNEY
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5677 KIPPEN DRIVE
Mailing Address - Street 2:
Mailing Address - City:EAST AMHERST
Mailing Address - State:NY
Mailing Address - Zip Code:14051-1969
Mailing Address - Country:US
Mailing Address - Phone:716-689-0342
Mailing Address - Fax:
Practice Address - Street 1:4232 SHELBY BASIN RD
Practice Address - Street 2:
Practice Address - City:MEDINA
Practice Address - State:NY
Practice Address - Zip Code:14132
Practice Address - Country:US
Practice Address - Phone:716-868-6783
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-05-05
Last Update Date:2011-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY6283225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist