Provider Demographics
NPI:1215095039
Name:HAND, DEANNA RAE (MS, ATC)
Entity type:Individual
Prefix:
First Name:DEANNA
Middle Name:RAE
Last Name:HAND
Suffix:
Gender:F
Credentials:MS, ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:53 BROOKLYN ST
Mailing Address - Street 2:
Mailing Address - City:ANGELICA
Mailing Address - State:NY
Mailing Address - Zip Code:14709-8708
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1 WILLARD AVE
Practice Address - Street 2:NIELSEN PEC
Practice Address - City:HOUGHTON
Practice Address - State:NY
Practice Address - Zip Code:14744
Practice Address - Country:US
Practice Address - Phone:585-567-9563
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY000768-12255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer