Basic Information
| Provider Information | |||||||||
| NPI: | 1396910444 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | FARLEIGH GARDNER | ||||||||
| FirstName: | PAMELA | ||||||||
| MiddleName: | ANNE | ||||||||
| NamePrefix: | MRS. | ||||||||
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| Credential: | P.T.A | ||||||||
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| Mailing Information | |||||||||
| Address1: | 90 OAK AVE | ||||||||
| Address2: | |||||||||
| City: | MATAMORAS | ||||||||
| State: | PA | ||||||||
| PostalCode: | 183362004 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5705045653 | ||||||||
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| Practice Location | |||||||||
| Address1: | 220 WHITE PLAINS ROAD | ||||||||
| Address2: | |||||||||
| City: | TARRYTOWN | ||||||||
| State: | NEW YORK | ||||||||
| PostalCode: | 10591 | ||||||||
| CountryCode: | UM | ||||||||
| TelephoneNumber: | 9146319020 | ||||||||
| FaxNumber: | 9146319028 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/29/2008 | ||||||||
| LastUpdateDate: | 04/29/2008 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225200000X | TE001601L | PA | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapy Assistant |
No ID Information.