Provider Demographics
NPI:1831491455
Name:ARNOLD, JOANNE SIERGIEJ (PT)
Entity Type:Individual
Prefix:
First Name:JOANNE
Middle Name:SIERGIEJ
Last Name:ARNOLD
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 1:113 CHERRY ST
Mailing Address - Street 2:PO BOX 131
Mailing Address - City:SOUTH DAYTON
Mailing Address - State:NY
Mailing Address - Zip Code:14138-9770
Mailing Address - Country:US
Mailing Address - Phone:716-988-3106
Mailing Address - Fax:
Practice Address - Street 1:113 CHERRY ST
Practice Address - Street 2:
Practice Address - City:SOUTH DAYTON
Practice Address - State:NY
Practice Address - Zip Code:14138-9770
Practice Address - Country:US
Practice Address - Phone:716-988-3106
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-12-02
Last Update Date:2010-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY004158225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist