Basic Information
| Provider Information | |||||||||
| NPI: | 1942237979 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | DUNCAN | ||||||||
| FirstName: | ANDREW | ||||||||
| MiddleName: | THOMAS | ||||||||
| NamePrefix: | MR. | ||||||||
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| Credential: | PT, ATC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 21 CHASE VIEW RD | ||||||||
| Address2: | |||||||||
| City: | FAIRPORT | ||||||||
| State: | NY | ||||||||
| PostalCode: | 144509769 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5852233159 | ||||||||
| FaxNumber: | 5853409745 | ||||||||
| Practice Location | |||||||||
| Address1: | 4901 LAC DE VILLE BLVD | ||||||||
| Address2: | BLDG D, SUITE 110 | ||||||||
| City: | ROCHESTER | ||||||||
| State: | NY | ||||||||
| PostalCode: | 146185647 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5853419135 | ||||||||
| FaxNumber: | 5853409745 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/26/2006 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2251S0007X | 012194-1 | NY | X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist | Sports | 2255A2300X | 000745 | NY | X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Specialist/Technologist | Athletic Trainer |
No ID Information.