Provider Demographics
NPI:1518564459
Name:BLONDELL, CATHERINE ZAHN (DPT)
Entity Type:Individual
Prefix:
First Name:CATHERINE
Middle Name:ZAHN
Last Name:BLONDELL
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 1:1900 STATE ROAD 31
Mailing Address - Street 2:SUITE 12
Mailing Address - City:MACEDON
Mailing Address - State:NY
Mailing Address - Zip Code:14502-8643
Mailing Address - Country:US
Mailing Address - Phone:315-986-4655
Mailing Address - Fax:315-986-5901
Practice Address - Street 1:1900 STATE ROAD 31
Practice Address - Street 2:SUITE 12
Practice Address - City:MACEDON
Practice Address - State:NY
Practice Address - Zip Code:14502-8643
Practice Address - Country:US
Practice Address - Phone:315-986-4655
Practice Address - Fax:315-986-5901
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-05
Last Update Date:2020-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY046016225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist