Patricia Jean Boehlert

Individual provider Active NPI Physical Therapist · Fayetteville, NY

NPI 1245870187 · NPPES record last updated Jan 8, 2020

Key facts

NPI
1245870187
Entity type
Individual (NPI type 1)
Primary specialty
Physical Therapist 225100000X
License
010847-1 (NY)
Practice address
4401 Medical Center Dr Ste 401
Fayetteville, NY 13066-6603
Phone
(315) 329-2550
Fax
(315) 744-1947
NPI assigned
Jan 8, 2020
Sex
Female
Sole proprietor
No

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Practice roles

OrganizationSpecialtyStatusNew patients
St Josephs Hospital Health Center Past
since Jan 12, 2020
Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 010847-1 NY Yes

Addresses

Primary practice location

4401 Medical Center Dr Ste 401
Fayetteville, NY 13066-6603

Mailing address

4401 Medical Center Dr Ste 401
Fayetteville, NY 13066-6603
Phone (315) 329-2550

Other providers in Fayetteville, NY

All providers in Fayetteville, NY · Physical Therapist in New York

Sources for this page

Verify at the official NPI Registry.