Provider Demographics
NPI:1205805314
Name:AEBISCHER, KATHLEEN L (PT)
Entity type:Individual
Prefix:
First Name:KATHLEEN
Middle Name:L
Last Name:AEBISCHER
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:KATHLEEN
Other - Middle Name:L
Other - Last Name:LINDAMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:6301 TRANSIT RD
Mailing Address - Street 2:
Mailing Address - City:DEPEW
Mailing Address - State:NY
Mailing Address - Zip Code:14043-1051
Mailing Address - Country:US
Mailing Address - Phone:716-684-0400
Mailing Address - Fax:716-683-7028
Practice Address - Street 1:545 DELAWARE ST
Practice Address - Street 2:
Practice Address - City:TONAWANDA
Practice Address - State:NY
Practice Address - Zip Code:14150
Practice Address - Country:US
Practice Address - Phone:716-694-5385
Practice Address - Fax:716-694-5386
Is Sole Proprietor?:No
Enumeration Date:2006-03-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY000623034002OtherBLUE CROSS BLUE SHIELD
NY9305841OtherIHA
NY0404260003529OtherFIDELIS
NY6602438OtherGHI
NY812266OtherMANAGED PHYSICAL NETWORK
NY00011174501OtherUNIVERA
NY000623034002OtherBLUE CROSS BLUE SHIELD