Provider Demographics
NPI:1306262910
Name:TASHMAN, LUCINDA LEIGH (PT)
Entity type:Individual
Prefix:
First Name:LUCINDA
Middle Name:LEIGH
Last Name:TASHMAN
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7307 HERON VIEW CT APT C
Mailing Address - Street 2:
Mailing Address - City:VICTOR
Mailing Address - State:NY
Mailing Address - Zip Code:14564-9451
Mailing Address - Country:US
Mailing Address - Phone:607-592-3054
Mailing Address - Fax:
Practice Address - Street 1:2359 N TRIPHAMMER RD
Practice Address - Street 2:
Practice Address - City:ITHACA
Practice Address - State:NY
Practice Address - Zip Code:14850-1059
Practice Address - Country:US
Practice Address - Phone:607-257-5009
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-03-07
Last Update Date:2022-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY9584225100000X
NY009584-01225100000X
NY009584-12251X0800X
NY009584225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
No2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic