Provider Demographics
NPI:1215177258
Name:NEAL, BARB Y (PTA)
Entity type:Individual
Prefix:MS
First Name:BARB
Middle Name:Y
Last Name:NEAL
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13903 QUAKER STREET
Mailing Address - Street 2:
Mailing Address - City:COLLINS
Mailing Address - State:NY
Mailing Address - Zip Code:14034
Mailing Address - Country:US
Mailing Address - Phone:716-490-1440
Mailing Address - Fax:866-902-1160
Practice Address - Street 1:774 FAIRMOUNT AVE
Practice Address - Street 2:
Practice Address - City:JAMESTOWN
Practice Address - State:NY
Practice Address - Zip Code:14701-2609
Practice Address - Country:US
Practice Address - Phone:716-665-1166
Practice Address - Fax:866-902-1160
Is Sole Proprietor?:Yes
Enumeration Date:2009-03-04
Last Update Date:2013-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY006977-1225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant