Provider Demographics
NPI:1568743144
Name:TERWILLIGER, ELAINE (PT)
Entity Type:Individual
Prefix:MRS
First Name:ELAINE
Middle Name:
Last Name:TERWILLIGER
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:355 HARLEM RD
Mailing Address - Street 2:
Mailing Address - City:WEST SENECA
Mailing Address - State:NY
Mailing Address - Zip Code:14224-1825
Mailing Address - Country:US
Mailing Address - Phone:716-310-0064
Mailing Address - Fax:
Practice Address - Street 1:355 HARLEM RD
Practice Address - Street 2:
Practice Address - City:WEST SENECA
Practice Address - State:NY
Practice Address - Zip Code:14224-1825
Practice Address - Country:US
Practice Address - Phone:716-310-0064
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-08
Last Update Date:2011-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0069892251P0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatrics