Provider Demographics
NPI:1376868257
Name:ALBERT, MEREDITH CORBETT (PT,CSCS,MDT)
Entity type:Individual
Prefix:
First Name:MEREDITH
Middle Name:CORBETT
Last Name:ALBERT
Suffix:
Gender:F
Credentials:PT,CSCS,MDT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1398 ROUTE 5 WEST
Mailing Address - Street 2:
Mailing Address - City:CHITTENANGO
Mailing Address - State:NY
Mailing Address - Zip Code:13037
Mailing Address - Country:US
Mailing Address - Phone:315-510-3372
Mailing Address - Fax:315-510-3688
Practice Address - Street 1:1398 ROUTE 5 WEST
Practice Address - Street 2:
Practice Address - City:CHITTENANGO
Practice Address - State:NY
Practice Address - Zip Code:13037
Practice Address - Country:US
Practice Address - Phone:315-510-3372
Practice Address - Fax:315-510-3688
Is Sole Proprietor?:No
Enumeration Date:2010-04-02
Last Update Date:2016-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0169891225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
12091819OtherCAQH
NY1376868257OtherNPI