Paulette Ruth Estabrooks, BS ATC
Individual provider Active NPI Athletic Trainer · Nineveh, NY
NPI 1336668953 · NPPES record last updated Sep 14, 2017
Key facts
- NPI
- 1336668953
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Athletic Trainer 2255A2300X
- License
- 002273 (NY)
- Practice address
- 35 Silverstein Rd
Nineveh, NY 13813-1135 - Phone
- (607) 242-2962
- NPI assigned
- Sep 14, 2017
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Bachelor of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 002273 | NY | MD | Athletic Trainer |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Athletic Trainer | 2255A2300X | 002273 | NY | Yes |
Addresses
Primary practice location
35 Silverstein Rd
Nineveh, NY 13813-1135
Mailing address
35 Silverstein Rd
Nineveh, NY 13813-1135
Other providers in Nineveh, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 14, 2017. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.