Provider Demographics
NPI:1255886263
Name:SCHOELL, KATHLEEN (PT DPT)
Entity type:Individual
Prefix:
First Name:KATHLEEN
Middle Name:
Last Name:SCHOELL
Suffix:
Gender:F
Credentials:PT DPT
Other - Prefix:
Other - First Name:KATHLEEN
Other - Middle Name:
Other - Last Name:COVNEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT DPT
Mailing Address - Street 1:74 JOLLS LN
Mailing Address - Street 2:
Mailing Address - City:ORCHARD PARK
Mailing Address - State:NY
Mailing Address - Zip Code:14127-2548
Mailing Address - Country:US
Mailing Address - Phone:585-727-2869
Mailing Address - Fax:
Practice Address - Street 1:3646 CALIFORNIA RD
Practice Address - Street 2:
Practice Address - City:ORCHARD PARK
Practice Address - State:NY
Practice Address - Zip Code:14127-1716
Practice Address - Country:US
Practice Address - Phone:585-727-2869
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-08-19
Last Update Date:2023-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY040417225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY06012380Medicaid