Individual
ANN M DESOTELLE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS PT
Contact information
Practice address
5225 SHERIDAN DR, WILLIAMSVILLE, NY 14221-3573
(716) 631-2626
(716) 631-2937
Mailing address
5225 SHERIDAN DR, WILLIAMSVILLE, NY 14221-3573
(716) 631-2626
(716) 631-2937
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
012083
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00011173401
UNIVERA
NY
01
—
006112451
BLUE CROSS
NY
01
—
9305462
IHA
NY
Enumeration date
03/07/2007
Last updated
01/04/2010
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