Provider Demographics
NPI:1801961693
Name:THOMPSON, NANETTE P (PT)
Entity type:Individual
Prefix:MRS
First Name:NANETTE
Middle Name:P
Last Name:THOMPSON
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:NANETTE
Other - Middle Name:
Other - Last Name:PICCARRETO
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:200 LINDEN OAKS STE 300
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14625-2841
Mailing Address - Country:US
Mailing Address - Phone:585-264-9440
Mailing Address - Fax:585-264-1489
Practice Address - Street 1:200 LINDEN OAKS STE 300
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14625-2841
Practice Address - Country:US
Practice Address - Phone:585-264-9440
Practice Address - Fax:585-264-1489
Is Sole Proprietor?:No
Enumeration Date:2006-11-21
Last Update Date:2019-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY01379712251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY103116FTOtherPREFERRED CARE
NY7344272OtherAETNA
NYP010013797OtherBLUE CHOICE