Nicole M Didas, DPT

Individual provider Active NPI Physical Therapist · Horseheads, NY

NPI 1215212832 · NPPES record last updated Oct 14, 2011

Key facts

NPI
1215212832
Entity type
Individual (NPI type 1)
Primary specialty
Physical Therapist 225100000X
License
027367-1 (NY)
Practice address
100 John Roemmelt Dr
Suite 100
Horseheads, NY 14845-8301
Phone
(607) 796-5934
Fax
(607) 796-4922
NPI assigned
Oct 14, 2011
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
027367-1NYMDPhysical Therapist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 027367-1 NY Yes

Addresses

Primary practice location

100 John Roemmelt Dr
Suite 100
Horseheads, NY 14845-8301

Mailing address

100 John Roemmelt Dr
Suite 100
Horseheads, NY 14845-8301

Other providers in Horseheads, NY

All providers in Horseheads, NY · Physical Therapist in New York

Sources for this page

Verify at the official NPI Registry.