Provider Demographics
NPI:1952040420
Name:SCHANBACHER, BENJAMEN WALTER
Entity Type:Individual
Prefix:
First Name:BENJAMEN
Middle Name:WALTER
Last Name:SCHANBACHER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:133 N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:HORSEHEADS
Mailing Address - State:NY
Mailing Address - Zip Code:14845-2175
Mailing Address - Country:US
Mailing Address - Phone:607-739-1700
Mailing Address - Fax:607-739-1792
Practice Address - Street 1:133 N MAIN ST
Practice Address - Street 2:
Practice Address - City:HORSEHEADS
Practice Address - State:NY
Practice Address - Zip Code:14845-2175
Practice Address - Country:US
Practice Address - Phone:607-739-1700
Practice Address - Fax:607-739-1792
Is Sole Proprietor?:No
Enumeration Date:2022-06-02
Last Update Date:2022-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist