Provider Demographics
NPI:1134937600
Name:GIBSON, HELEN (DPT)
Entity type:Individual
Prefix:
First Name:HELEN
Middle Name:
Last Name:GIBSON
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8865 SHERIDAN DR
Mailing Address - Street 2:
Mailing Address - City:CLARENCE
Mailing Address - State:NY
Mailing Address - Zip Code:14031-1458
Mailing Address - Country:US
Mailing Address - Phone:716-276-3196
Mailing Address - Fax:716-276-9207
Practice Address - Street 1:8865 SHERIDAN DR
Practice Address - Street 2:
Practice Address - City:CLARENCE
Practice Address - State:NY
Practice Address - Zip Code:14031-1458
Practice Address - Country:US
Practice Address - Phone:716-276-3196
Practice Address - Fax:716-276-9207
Is Sole Proprietor?:No
Enumeration Date:2024-12-30
Last Update Date:2024-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY053359-01225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist