Provider Demographics
NPI:1538134093
Name:SCHANEY, CLARENCE RAYMOND (PT, DSC, ECS)
Entity Type:Individual
Prefix:DR
First Name:CLARENCE
Middle Name:RAYMOND
Last Name:SCHANEY
Suffix:
Gender:M
Credentials:PT, DSC, ECS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300 STATE STREET
Mailing Address - Street 2:SUITE 209
Mailing Address - City:ERIE
Mailing Address - State:PA
Mailing Address - Zip Code:16507-1428
Mailing Address - Country:US
Mailing Address - Phone:814-454-5251
Mailing Address - Fax:814-459-1884
Practice Address - Street 1:300 STATE STREET
Practice Address - Street 2:SUITE 209
Practice Address - City:ERIE
Practice Address - State:PA
Practice Address - Zip Code:16507-1428
Practice Address - Country:US
Practice Address - Phone:814-454-5251
Practice Address - Fax:814-459-1884
Is Sole Proprietor?:No
Enumeration Date:2006-02-20
Last Update Date:2015-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT002944L2251E1300X
PADAPT0003612251E1300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251E1300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistElectrophysiology, Clinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1028777270001Medicaid
PA1028777270001Medicaid