Provider Demographics
NPI:1477525582
Name:BEARER, JOHN E (PT)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:E
Last Name:BEARER
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:37 N UNION STREET
Mailing Address - Street 2:
Mailing Address - City:SPENCERPORT
Mailing Address - State:NY
Mailing Address - Zip Code:14559
Mailing Address - Country:US
Mailing Address - Phone:585-349-2860
Mailing Address - Fax:585-349-2995
Practice Address - Street 1:37 N UNION STREET
Practice Address - Street 2:
Practice Address - City:SPENCERPORT
Practice Address - State:NY
Practice Address - Zip Code:14559
Practice Address - Country:US
Practice Address - Phone:585-349-2860
Practice Address - Fax:585-349-2995
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-02
Last Update Date:2008-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY005201225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYP012005201OtherBCBS
NY7024316OtherAETNA
NYP011005201OtherBLUE CHOICE
NY10076FTOtherPREFERRED CARE
NYP012005201OtherBCBS