Provider Demographics
NPI:1902111222
Name:WARD, PAMELA LEE (PT, DPT, C/NDT)
Entity Type:Individual
Prefix:DR
First Name:PAMELA
Middle Name:LEE
Last Name:WARD
Suffix:
Gender:F
Credentials:PT, DPT, C/NDT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:170 W SHORE DR
Mailing Address - Street 2:
Mailing Address - City:NEW MILFORD
Mailing Address - State:PA
Mailing Address - Zip Code:18834-7638
Mailing Address - Country:US
Mailing Address - Phone:570-465-3329
Mailing Address - Fax:
Practice Address - Street 1:170 W SHORE DR
Practice Address - Street 2:
Practice Address - City:NEW MILFORD
Practice Address - State:PA
Practice Address - Zip Code:18834-7638
Practice Address - Country:US
Practice Address - Phone:570-465-3329
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-11
Last Update Date:2010-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT002366E2251P0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatrics