Provider Demographics
NPI:1134150907
Name:WRIGHT, LAURA JEAN (MPT)
Entity type:Individual
Prefix:
First Name:LAURA
Middle Name:JEAN
Last Name:WRIGHT
Suffix:
Gender:F
Credentials:MPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8750 TRANSIT RD
Mailing Address - Street 2:SUITE 120
Mailing Address - City:E AMHERST
Mailing Address - State:NY
Mailing Address - Zip Code:14051
Mailing Address - Country:US
Mailing Address - Phone:716-568-1251
Mailing Address - Fax:716-568-1253
Practice Address - Street 1:8750 TRANSIT RD
Practice Address - Street 2:SUITE 120
Practice Address - City:E AMHERST
Practice Address - State:NY
Practice Address - Zip Code:14051
Practice Address - Country:US
Practice Address - Phone:716-568-1251
Practice Address - Fax:716-568-1253
Is Sole Proprietor?:No
Enumeration Date:2006-07-06
Last Update Date:2009-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY026334225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYRA6523Medicare PIN