Provider Demographics
NPI:1487204038
Name:BERG-SPINDELMAN, MONIQUE SUSANNE (DPT)
Entity Type:Individual
Prefix:DR
First Name:MONIQUE
Middle Name:SUSANNE
Last Name:BERG-SPINDELMAN
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4 CEDARWOOD CIR
Mailing Address - Street 2:
Mailing Address - City:PITTSFORD
Mailing Address - State:NY
Mailing Address - Zip Code:14534-3246
Mailing Address - Country:US
Mailing Address - Phone:585-415-1240
Mailing Address - Fax:585-244-0664
Practice Address - Street 1:4 CEDARWOOD CIR
Practice Address - Street 2:
Practice Address - City:PITTSFORD
Practice Address - State:NY
Practice Address - Zip Code:14534-3246
Practice Address - Country:US
Practice Address - Phone:585-415-1240
Practice Address - Fax:585-244-0664
Is Sole Proprietor?:Yes
Enumeration Date:2019-09-16
Last Update Date:2019-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0126062251G0304X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251G0304XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGeriatrics