Provider Demographics
NPI:1457516890
Name:SCHAEFER, ANN L (PT)
Entity type:Individual
Prefix:
First Name:ANN
Middle Name:L
Last Name:SCHAEFER
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 1:2880 KULP RD
Mailing Address - Street 2:
Mailing Address - City:EDEN
Mailing Address - State:NY
Mailing Address - Zip Code:14057-9411
Mailing Address - Country:US
Mailing Address - Phone:716-992-2052
Mailing Address - Fax:
Practice Address - Street 1:2880 KULP RD
Practice Address - Street 2:
Practice Address - City:EDEN
Practice Address - State:NY
Practice Address - Zip Code:14057-9411
Practice Address - Country:US
Practice Address - Phone:716-992-2052
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-24
Last Update Date:2008-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY008321-1225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist