Trevor Glenn Gleason, PTA
Individual provider Active NPI Physical Therapy Assistant · Clymer, NY
NPI 1992157473 · NPPES record last updated Jul 7, 2016
Key facts
- NPI
- 1992157473
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapy Assistant 225200000X
- License
- 2120638 (TX)
- Practice address
- 2291 Marks Rd
Clymer, NY 14724-9742 - Phone
- (716) 499-9925
- NPI assigned
- Jul 7, 2016
- Sex
- Male
- 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 |
|---|---|---|---|
| 2120638 | TX | MD | Physical Therapy Assistant |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapy Assistant | 225200000X | 2120638 | TX | Yes |
Addresses
Primary practice location
2291 Marks Rd
Clymer, NY 14724-9742
Mailing address
2291 Marks Rd
Clymer, NY 14724-9742
Phone (716) 499-9925
Other providers in Clymer, NY
- Clymer Volunteer Fire Company, Inc.
- Corry Medical Services, Inc
- Corry Medical Services, Inc.
- Corry Memorial Hospital Association
- Brent L Deuink
- John Joseph Letzo
- Kimberly Diane Phillips
- Sara Ann Sullivan
All providers in Clymer, 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 Jul 7, 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.