Provider Demographics
NPI:1801408885
Name:HERUBIN, CLARE MARIE (DPT)
Entity Type:Individual
Prefix:
First Name:CLARE
Middle Name:MARIE
Last Name:HERUBIN
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 1:21 FLEETWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:ALBANY
Mailing Address - State:NY
Mailing Address - Zip Code:12208-2307
Mailing Address - Country:US
Mailing Address - Phone:518-817-5095
Mailing Address - Fax:
Practice Address - Street 1:21 FLEETWOOD AVE
Practice Address - Street 2:
Practice Address - City:ALBANY
Practice Address - State:NY
Practice Address - Zip Code:12208-2307
Practice Address - Country:US
Practice Address - Phone:518-817-5095
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-08-20
Last Update Date:2020-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist