Nathaniel Orien Haller, DPT
Individual provider Active NPI Physical Therapist · Skaneateles, NY
NPI 1548024276 · NPPES record last updated Feb 13, 2024
Key facts
- NPI
- 1548024276
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapist 225100000X
- License
- 052072 (NY)
- Practice address
- 810 W Genesee Street Rd
Skaneateles, NY 13152-9311 - Phone
- (315) 291-7042
- Fax
- (315) 291-7048
- NPI assigned
- Feb 13, 2024
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 052072 | NY | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Shelly Kraetz | Physical Therapist | Current |
Accepting new patients |
| Kraetz Holdings LLC | Physical Therapist | Current |
Accepting new patients |
Locations
5639 W Genesee St
Camillus, NY 13031
Phone (315) 468-2985
810 W Genesee Street Rd
Skaneateles, NY 13152
Phone (315) 291-7042
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 052072 | NY | Yes |
Addresses
Primary practice location
810 W Genesee Street Rd
Skaneateles, NY 13152-9311
Mailing address
3481 Fourwheel Dr
Tully, NY 13159-9623
Phone (607) 842-6962
Other practice location 1
5639 W Genesee St
Camillus, NY 13031-1250
Phone (315) 291-7042
Other providers in Skaneateles, NY
- Marjorie Komp Graham
- Stephanie Gregory
- Patrick Griffin
- Vicki J Guy
- Richard Nicholas Hahn
- Douglas William Halliday
- Serena A. Hamel
- Alison Hellwig
- Mary Ellen Hennigan
- Jaebsary Patient Transport, Inc.
All providers in Skaneateles, NY · Physical Therapist in New York
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 13, 2024. 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.