Provider Demographics
NPI:1275045148
Name:ALBRECHT, BONNIE V (RPT)
Entity Type:Individual
Prefix:MS
First Name:BONNIE
Middle Name:V
Last Name:ALBRECHT
Suffix:
Gender:F
Credentials:RPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5335 E RIVER RD
Mailing Address - Street 2:
Mailing Address - City:GRAND ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:14072-1132
Mailing Address - Country:US
Mailing Address - Phone:716-775-5312
Mailing Address - Fax:
Practice Address - Street 1:5335 E RIVER RD
Practice Address - Street 2:
Practice Address - City:GRAND ISLAND
Practice Address - State:NY
Practice Address - Zip Code:14072-1132
Practice Address - Country:US
Practice Address - Phone:716-775-5312
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-10-31
Last Update Date:2017-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY009067225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist