Provider Demographics
NPI:1770941643
Name:SCHMIDT, CONOR (DPT)
Entity type:Individual
Prefix:
First Name:CONOR
Middle Name:
Last Name:SCHMIDT
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:91 POINT JUDITH RD UNIT D7
Mailing Address - Street 2:
Mailing Address - City:NARRAGANSETT
Mailing Address - State:RI
Mailing Address - Zip Code:02882-3468
Mailing Address - Country:US
Mailing Address - Phone:401-584-9098
Mailing Address - Fax:401-515-7641
Practice Address - Street 1:91 POINT JUDITH RD UNIT D7
Practice Address - Street 2:
Practice Address - City:NARRAGANSETT
Practice Address - State:RI
Practice Address - Zip Code:02882-3468
Practice Address - Country:US
Practice Address - Phone:401-584-9098
Practice Address - Fax:401-515-7641
Is Sole Proprietor?:No
Enumeration Date:2016-02-05
Last Update Date:2022-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY041485-1225100000X
RIPT03363225100000X
CT10808225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist