Active NPI
Pamela Leclair, PT
- Physical Therapist
- East Longmeadow, MA
National Provider Identifier
1104839034
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 11752
- Practice address
- 45 Crane Ave
East Longmeadow, MA 01028-2331 - Phone
- (413) 525-7813
- NPI assigned
- Aug 14, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 11752 | MA | Primary |
Addresses
Primary practice location
45 Crane Ave
East Longmeadow, MA 01028-2331
Mailing address
88 Oak Knoll Dr
Hampden, MA 01036-9741
Phone (413) 654-9643
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 004209773 | Medicaid | CT |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 11752 | MA | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1155513600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1595808000000",
"number": "1104839034",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "88 OAK KNOLL DR",
"city": "HAMPDEN",
"state": "MA",
"postal_code": "010369741",
"telephone_number": "413-654-9643"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "45 CRANE AVE",
"city": "EAST LONGMEADOW",
"state": "MA",
"postal_code": "010282331",
"telephone_number": "413-525-7813"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LECLAIR",
"first_name": "PAMELA",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-08-14",
"last_updated": "2020-07-27",
"certification_date": "2020-07-27",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "MA",
"license": "11752",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "004209773",
"state": "CT"
}
],
"endpoints": [],
"other_names": []
}Other providers in East Longmeadow, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 27, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.