Provider Demographics
NPI:1477663359
Name:STRAW, CHLOE MAE (MSPT)
Entity Type:Individual
Prefix:
First Name:CHLOE
Middle Name:MAE
Last Name:STRAW
Suffix:
Gender:F
Credentials:MSPT
Other - Prefix:
Other - First Name:CHLOE
Other - Middle Name:MAE
Other - Last Name:RICHARDS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MSPT
Mailing Address - Street 1:2416 CONSTITUTION AVE
Mailing Address - Street 2:REHABILITATION TODAY
Mailing Address - City:OLEAN
Mailing Address - State:NY
Mailing Address - Zip Code:14760
Mailing Address - Country:US
Mailing Address - Phone:716-372-2808
Mailing Address - Fax:716-372-2902
Practice Address - Street 1:2416 CONSTITUTION AVE
Practice Address - Street 2:REHABILITATION TODAY
Practice Address - City:OLEAN
Practice Address - State:NY
Practice Address - Zip Code:14760
Practice Address - Country:US
Practice Address - Phone:716-372-2808
Practice Address - Fax:716-372-2902
Is Sole Proprietor?:No
Enumeration Date:2006-08-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY026545225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYP00262929OtherMEDICARE RAILROAD
NYB2598447Medicaid
NYB2598447Medicaid
Q30018Medicare UPIN