Provider Demographics
NPI:1437104163
Name:GREBNER, AMBUR (DPT)
Entity Type:Individual
Prefix:
First Name:AMBUR
Middle Name:
Last Name:GREBNER
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:AMBUR
Other - Middle Name:
Other - Last Name:CHENELLY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DPT
Mailing Address - Street 1:800 CARTER STREET
Mailing Address - Street 2:ATTN KELLY STEELE
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14621
Mailing Address - Country:US
Mailing Address - Phone:585-339-4793
Mailing Address - Fax:585-336-4845
Practice Address - Street 1:800 CARTER ST
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14621-2604
Practice Address - Country:US
Practice Address - Phone:585-338-1400
Practice Address - Fax:585-336-4845
Is Sole Proprietor?:No
Enumeration Date:2006-05-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0272621225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY11514673OtherCAQH
NY00355266Medicaid
NY5361OtherSIDNEY HILLMAN
NY2579671OtherUNITED HEALTH CARE
NYP00357141OtherMEDICARE RAILROAD
NYP0140059WHOtherBLUE CHOICE
NYFA0501OtherPREFERRED CARE
NY00027338501OtherUNIVERA
NY00355266Medicaid