Provider Demographics
NPI:1477835056
Name:GEDEON, PAULA M (PT, CHT)
Entity Type:Individual
Prefix:
First Name:PAULA
Middle Name:M
Last Name:GEDEON
Suffix:
Gender:F
Credentials:PT, CHT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5144 SHERIDAN DRIVE
Mailing Address - Street 2:#2
Mailing Address - City:BUFFALO
Mailing Address - State:NY
Mailing Address - Zip Code:14221-4653
Mailing Address - Country:US
Mailing Address - Phone:716-631-5224
Mailing Address - Fax:716-631-5626
Practice Address - Street 1:5144 SHERIDAN DR
Practice Address - Street 2:#2
Practice Address - City:BUFFALO
Practice Address - State:NY
Practice Address - Zip Code:14221-4653
Practice Address - Country:US
Practice Address - Phone:716-631-5224
Practice Address - Fax:716-631-5626
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-09
Last Update Date:2012-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY007915-12251H1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251H1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistHand