Provider Demographics
NPI:1336350271
Name:BISHOP, ANN RIKLI (PT)
Entity Type:Individual
Prefix:MRS
First Name:ANN
Middle Name:RIKLI
Last Name:BISHOP
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:208 HILLCREST RD
Mailing Address - Street 2:
Mailing Address - City:ELMIRA
Mailing Address - State:NY
Mailing Address - Zip Code:14903-7972
Mailing Address - Country:US
Mailing Address - Phone:607-733-0521
Mailing Address - Fax:
Practice Address - Street 1:11849 E CORNING RD
Practice Address - Street 2:SUITE 108
Practice Address - City:CORNING
Practice Address - State:NY
Practice Address - Zip Code:14830
Practice Address - Country:US
Practice Address - Phone:607-962-0102
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY003643-1225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist