Provider Demographics
NPI:1891854634
Name:SCHNELLINGER, DINA (PA, PT)
Entity Type:Individual
Prefix:MRS
First Name:DINA
Middle Name:
Last Name:SCHNELLINGER
Suffix:
Gender:F
Credentials:PA, PT
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Mailing Address - Street 1:17 LANSING ST
Mailing Address - Street 2:MEDICAL STAFF COORDINATOR
Mailing Address - City:AUBURN
Mailing Address - State:NY
Mailing Address - Zip Code:13021-1983
Mailing Address - Country:US
Mailing Address - Phone:315-255-7202
Mailing Address - Fax:315-255-7289
Practice Address - Street 1:17 LANSING ST
Practice Address - Street 2:MEDICAL STAFF COORDINATOR
Practice Address - City:AUBURN
Practice Address - State:NY
Practice Address - Zip Code:13021-1983
Practice Address - Country:US
Practice Address - Phone:315-255-7202
Practice Address - Fax:315-255-7289
Is Sole Proprietor?:No
Enumeration Date:2006-12-07
Last Update Date:2016-10-24
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAPT24811208100000X
NY017116363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAPT24811OtherLICENSE NUMBER