| Organization Name: | ELIZABETH MARABELLA PECK, PT, DPT, PLLC |
| NPI Number: | 1225386295 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | ELIZABETH ANN PECK (OWNER) |
| Mailing Address: | 105 Main St Suite 2 North Tonawanda |
| State: | NY US |
| Postal Code: | 141205308 |
| Phone Number: | 7166926388 |
| Fax Number: | 7166921227 |
| NPI Enumeration Date: | 08/26/2012 |
| NPI Last Update Date: | 08/26/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QP2000X |
| License Number: | 17364-1 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NY |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Physical Therapy |
| Taxonomy Definition: | |