Provider Demographics
NPI:1487605374
Name:MCCAY, NANCY MARIE (BSPT)
Entity type:Individual
Prefix:
First Name:NANCY
Middle Name:MARIE
Last Name:MCCAY
Suffix:
Gender:F
Credentials:BSPT
Other - Prefix:
Other - First Name:NANCY
Other - Middle Name:MARIE
Other - Last Name:NETTO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:6627 BRADHURST ST
Mailing Address - Street 2:
Mailing Address - City:VICTOR
Mailing Address - State:NY
Mailing Address - Zip Code:14564-9458
Mailing Address - Country:US
Mailing Address - Phone:253-278-0805
Mailing Address - Fax:
Practice Address - Street 1:1290 BLOSSOM DR STE B
Practice Address - Street 2:
Practice Address - City:VICTOR
Practice Address - State:NY
Practice Address - Zip Code:14564-1416
Practice Address - Country:US
Practice Address - Phone:253-278-0805
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-05-15
Last Update Date:2019-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPT00008865225100000X
NY014309225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA8333767Medicaid
WA8333767Medicaid
WAAB33764Medicare ID - Type Unspecified