Doctor Name: | MS. MARY ELLEN DOUGHERTY |
NPI Number: | 1215070198 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | PT |
License Number: | 005030-1 |
Business Practice Address: | 813 Fay Rd Syracuse, NY - 132193009 |
Business Phone Number: | 3157030762 |
Business Fax Number: | |
Mailing Address: | 167 Thurlow Dr, SYRACUSE |
State: | NY |
Postal Code: | 132052826 |
Phone Number: | 3154926720 |
Fax Number: | |
NPI Enumeration Date: | 02/14/2007 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 225100000X |
License Number: | 005030-1 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NY |
Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
Taxonomy Classification: | Physical Therapist |
Taxonomy Specialization: | |
Taxonomy Definition: | (1) Physical therapists are health care professionals who evaluate and treat people with health problems resulting from injury or disease. PT |