Provider Demographics
NPI:1881859783
Name:ZERN HEHIR, MOLLY ANN (PTA)
Entity Type:Individual
Prefix:MRS
First Name:MOLLY
Middle Name:ANN
Last Name:ZERN HEHIR
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:MISS
Other - First Name:MOLLY
Other - Middle Name:ANN
Other - Last Name:ZERN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PTA
Mailing Address - Street 1:2128 ELMWOOD AVENUE
Mailing Address - Street 2:
Mailing Address - City:BUFFALO
Mailing Address - State:NY
Mailing Address - Zip Code:14207-1910
Mailing Address - Country:US
Mailing Address - Phone:716-824-4500
Mailing Address - Fax:716-874-3195
Practice Address - Street 1:2128 ELMWOOD AVENUE
Practice Address - Street 2:
Practice Address - City:BUFFALO
Practice Address - State:NY
Practice Address - Zip Code:14207-1910
Practice Address - Country:US
Practice Address - Phone:716-824-4500
Practice Address - Fax:716-874-3195
Is Sole Proprietor?:No
Enumeration Date:2008-07-21
Last Update Date:2008-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY006275225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant