Provider Demographics
NPI:1417438920
Name:BURDETT, CLAIRE E (PT, DPT)
Entity Type:Individual
Prefix:
First Name:CLAIRE
Middle Name:E
Last Name:BURDETT
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:CLAIRE
Other - Middle Name:E
Other - Last Name:CANNON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2300 BUFFALO RD BLDG 300A
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14624-1369
Mailing Address - Country:US
Mailing Address - Phone:585-247-0080
Mailing Address - Fax:
Practice Address - Street 1:1670 EMPIRE BLVD STE 100
Practice Address - Street 2:
Practice Address - City:WEBSTER
Practice Address - State:NY
Practice Address - Zip Code:14580-2119
Practice Address - Country:US
Practice Address - Phone:585-671-0850
Practice Address - Fax:585-671-5242
Is Sole Proprietor?:No
Enumeration Date:2018-08-23
Last Update Date:2021-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY043365225100000X, 2251S0007X, 2251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No2251S0007XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistSports