Provider Demographics
NPI:1720122021
Name:LOWMAN DELLES, DONNA (PT)
Entity Type:Individual
Prefix:
First Name:DONNA
Middle Name:
Last Name:LOWMAN DELLES
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 1:3350 SOUTHWESTERN BLVD
Mailing Address - Street 2:
Mailing Address - City:ORCHARD PARK
Mailing Address - State:NY
Mailing Address - Zip Code:14127-1524
Mailing Address - Country:US
Mailing Address - Phone:716-677-2000
Mailing Address - Fax:716-677-2005
Practice Address - Street 1:3350 SOUTHWESTERN BLVD
Practice Address - Street 2:
Practice Address - City:ORCHARD PARK
Practice Address - State:NY
Practice Address - Zip Code:14127-1524
Practice Address - Country:US
Practice Address - Phone:716-677-2000
Practice Address - Fax:716-677-2005
Is Sole Proprietor?:No
Enumeration Date:2007-02-19
Last Update Date:2014-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY11434225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYRA8675Medicare ID - Type UnspecifiedMEDICARE ID