Provider Demographics
NPI:1851428999
Name:CHAUVOT, ELIZABETH B (PT)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:B
Last Name:CHAUVOT
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 1:109 WATERTROUGH RD
Mailing Address - Street 2:
Mailing Address - City:BERNE
Mailing Address - State:NY
Mailing Address - Zip Code:12023-3627
Mailing Address - Country:US
Mailing Address - Phone:518-872-2736
Mailing Address - Fax:
Practice Address - Street 1:251 COLE HILL ROAD
Practice Address - Street 2:
Practice Address - City:EAST BERNE
Practice Address - State:NY
Practice Address - Zip Code:12059
Practice Address - Country:US
Practice Address - Phone:518-872-1870
Practice Address - Fax:518-872-1800
Is Sole Proprietor?:No
Enumeration Date:2007-02-27
Last Update Date:2011-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY017072-1225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY10070940OtherCDPHP
NY390488OtherMVP
NY000409919001OtherBSNENY
NYJ400012568Medicare PIN