Provider Demographics
NPI:1346664257
Name:NEUMEISTER, ANDREW J (DPT)
Entity Type:Individual
Prefix:
First Name:ANDREW
Middle Name:J
Last Name:NEUMEISTER
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:489 WILKINSON RD
Mailing Address - Street 2:
Mailing Address - City:MACEDON
Mailing Address - State:NY
Mailing Address - Zip Code:14502-8809
Mailing Address - Country:US
Mailing Address - Phone:315-430-4419
Mailing Address - Fax:
Practice Address - Street 1:145 HAZARD AVE
Practice Address - Street 2:SUITE B
Practice Address - City:ENFIELD
Practice Address - State:CT
Practice Address - Zip Code:06082-4521
Practice Address - Country:US
Practice Address - Phone:860-265-2571
Practice Address - Fax:860-265-2574
Is Sole Proprietor?:No
Enumeration Date:2014-02-12
Last Update Date:2015-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY038725-1225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT10045OtherSTATE OF CT LICENSE