Provider Demographics
NPI:1760851018
Name:SHELDON, CLARE (PT, DPT)
Entity Type:Individual
Prefix:
First Name:CLARE
Middle Name:
Last Name:SHELDON
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8661 CHAMINADE RD APT 606
Mailing Address - Street 2:
Mailing Address - City:MARCY
Mailing Address - State:NY
Mailing Address - Zip Code:13403-3154
Mailing Address - Country:US
Mailing Address - Phone:607-226-4898
Mailing Address - Fax:
Practice Address - Street 1:600 CULVER AVE
Practice Address - Street 2:
Practice Address - City:UTICA
Practice Address - State:NY
Practice Address - Zip Code:13501-2015
Practice Address - Country:US
Practice Address - Phone:315-734-9904
Practice Address - Fax:315-734-9905
Is Sole Proprietor?:No
Enumeration Date:2015-09-16
Last Update Date:2015-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0393781225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist