Provider Demographics
NPI:1023894441
Name:REED, ADRIANA GRACE (PT, DPT)
Entity type:Individual
Prefix:
First Name:ADRIANA
Middle Name:GRACE
Last Name:REED
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1431 FOUR ROD RD
Mailing Address - Street 2:
Mailing Address - City:ALDEN
Mailing Address - State:NY
Mailing Address - Zip Code:14004-9420
Mailing Address - Country:US
Mailing Address - Phone:716-256-9961
Mailing Address - Fax:
Practice Address - Street 1:19 OLEAN ST
Practice Address - Street 2:
Practice Address - City:EAST AURORA
Practice Address - State:NY
Practice Address - Zip Code:14052-2513
Practice Address - Country:US
Practice Address - Phone:716-652-3127
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-09-01
Last Update Date:2023-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY051006225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist