Active NPI
Lynn Marie Neeson, PT, DPT
- Pediatric Physical Therapist
- Olean, NY
National Provider Identifier
1770790818
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Physical Therapist
- License
- 019640
- Practice address
- 742 Grandview Ave
Olean, NY 14760-2862 - Phone
- (716) 801-2311
- NPI assigned
- May 17, 2007
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Pediatric Physical Therapist | 2251P0200X | 019640 | NY | Primary |
Addresses
Primary practice location
742 Grandview Ave
Olean, NY 14760-2862
Mailing address
742 Grandview Ave
Olean, NY 14760-2862
Phone (716) 801-2311
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 019640 | NY | MD | Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1179360000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1219276800000",
"number": "1770790818",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "742 GRANDVIEW AVE",
"city": "OLEAN",
"state": "NY",
"postal_code": "147602862",
"telephone_number": "716-801-2311"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "742 GRANDVIEW AVE",
"city": "OLEAN",
"state": "NY",
"postal_code": "147602862",
"telephone_number": "716-801-2311"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NEESON",
"first_name": "LYNN",
"middle_name": "MARIE",
"name_prefix": "Mrs.",
"credential": "PT, DPT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-05-17",
"last_updated": "2008-08-21",
"status": "A"
},
"taxonomies": [
{
"code": "2251P0200X",
"taxonomy_group": "",
"desc": "Physical Therapist, Pediatrics",
"state": "NY",
"license": "019640",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Olean, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 21, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.