Provider Demographics
NPI:1366442303
Name:BULMAHN, AMY L (PT)
Entity Type:Individual
Prefix:
First Name:AMY
Middle Name:L
Last Name:BULMAHN
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:141 SULLYS TRL
Mailing Address - Street 2:SUITE 9
Mailing Address - City:PITTSFORD
Mailing Address - State:NY
Mailing Address - Zip Code:14534-4563
Mailing Address - Country:US
Mailing Address - Phone:585-387-0430
Mailing Address - Fax:585-387-0431
Practice Address - Street 1:141 SULLYS TRL
Practice Address - Street 2:SUITE 9
Practice Address - City:PITTSFORD
Practice Address - State:NY
Practice Address - Zip Code:14534-4563
Practice Address - Country:US
Practice Address - Phone:585-387-0430
Practice Address - Fax:585-387-0431
Is Sole Proprietor?:No
Enumeration Date:2005-07-29
Last Update Date:2012-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY022997225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYDD0987Medicare ID - Type Unspecified