Provider Demographics
NPI:1265599799
Name:GANEY, CLARE B (PT)
Entity type:Individual
Prefix:MRS
First Name:CLARE
Middle Name:B
Last Name:GANEY
Suffix:
Gender:F
Credentials:PT
Other - Prefix:MISS
Other - First Name:CLARE
Other - Middle Name:E
Other - Last Name:BUKOWSKI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:28 LOVERING AVE
Mailing Address - Street 2:
Mailing Address - City:BUFFALO
Mailing Address - State:NY
Mailing Address - Zip Code:14216-2310
Mailing Address - Country:US
Mailing Address - Phone:716-873-7136
Mailing Address - Fax:
Practice Address - Street 1:462 GRIDER ST
Practice Address - Street 2:
Practice Address - City:BUFFALO
Practice Address - State:NY
Practice Address - Zip Code:14215-3021
Practice Address - Country:US
Practice Address - Phone:716-898-5040
Practice Address - Fax:716-898-3259
Is Sole Proprietor?:No
Enumeration Date:2007-01-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY010168-1225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist