Provider Demographics
NPI:1629742598
Name:BISHEL, TIRZAH (PTA)
Entity Type:Individual
Prefix:
First Name:TIRZAH
Middle Name:
Last Name:BISHEL
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:71 GREGORY ST APT 2
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14620-1207
Mailing Address - Country:US
Mailing Address - Phone:209-606-8054
Mailing Address - Fax:
Practice Address - Street 1:1500 PORTLAND AVE
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14621-3065
Practice Address - Country:US
Practice Address - Phone:585-697-6000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-08-04
Last Update Date:2021-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant