Provider Demographics
NPI:1447513445
Name:OAR, DANA IRENE (MED, LMT)
Entity type:Individual
Prefix:MS
First Name:DANA
Middle Name:IRENE
Last Name:OAR
Suffix:
Gender:F
Credentials:MED, LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:295 MAIN ST
Mailing Address - Street 2:SUITE 740
Mailing Address - City:BUFFALO
Mailing Address - State:NY
Mailing Address - Zip Code:14203-2412
Mailing Address - Country:US
Mailing Address - Phone:716-854-4555
Mailing Address - Fax:
Practice Address - Street 1:295 MAIN ST
Practice Address - Street 2:SUITE 740
Practice Address - City:BUFFALO
Practice Address - State:NY
Practice Address - Zip Code:14203-2412
Practice Address - Country:US
Practice Address - Phone:716-854-4555
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-25
Last Update Date:2012-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY025087-1225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist