Provider Demographics
NPI:1831884006
Name:OBERNESSER, DONNA (MS PT)
Entity type:Individual
Prefix:
First Name:DONNA
Middle Name:
Last Name:OBERNESSER
Suffix:
Gender:F
Credentials:MS PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1800 BUTTERFIELD AVE
Mailing Address - Street 2:
Mailing Address - City:UTICA
Mailing Address - State:NY
Mailing Address - Zip Code:13501-5610
Mailing Address - Country:US
Mailing Address - Phone:315-797-3570
Mailing Address - Fax:
Practice Address - Street 1:1800 BUTTERFIELD AVE
Practice Address - Street 2:
Practice Address - City:UTICA
Practice Address - State:NY
Practice Address - Zip Code:13501-5610
Practice Address - Country:US
Practice Address - Phone:315-797-3570
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-04-05
Last Update Date:2023-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY028890-1225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist