Melissa Bedford
Individual provider Active NPI Physical Therapy Assistant · Burt, NY
NPI 1144765447 · NPPES record last updated Dec 23, 2016
Key facts
- NPI
- 1144765447
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapy Assistant 225200000X
- License
- 005485-1 (NY)
- Practice address
- 5676 W Lake Rd
Burt, NY 14028-9727 - Phone
- (716) 417-3609
- NPI assigned
- Dec 23, 2016
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 005485-1 | NY | MD | Physical Therapy Assistant |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapy Assistant | 225200000X | 005485-1 | NY | Yes |
Addresses
Primary practice location
5676 W Lake Rd
Burt, NY 14028-9727
Mailing address
5676 W Lake Rd
Burt, NY 14028-9727
Phone (716) 417-3609
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 005485-1 | Other | NY | STATE LICENSE |
Other providers in Burt, NY
- Functional Movement Physical Therapy
- Catherine Ann Giebner
- Janet Kathleen Hellner
- Katelynn Josephine Lang
- Rachel Platt
All providers in Burt, NY · Physical Therapy Assistant in New York
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 23, 2016. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.