Individual
MRS. AMY E WAITE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
P.T.
Contact information
Practice address
14379 ROUTE 9W, RAVENA, NY 12143
(518) 756-3124
(518) 756-9476
Mailing address
537 ROUTE 9W, GLENMONT, NY 12077-3703
(518) 436-7888
(518) 462-9162
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
019289-1
NY
252Y00000X
Early Intervention Provider Agency
019289-1
NY
Other
Enumeration date
11/11/2008
Last updated
06/13/2012
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