Diane P Fedor, PT

Primary specialty

Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X

License

007102-01 Issued in NY

Practice address

2834 County Highway 39
Worcester, NY 12197-4209

Phone

(607) 287-6751

NPI assigned

Nov 28, 2023

Last updated

Nov 28, 2023By the provider in NPPES

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1701129600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701129600000",
    "number": "1790551018",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2834 COUNTY HIGHWAY 39",
            "city": "WORCESTER",
            "state": "NY",
            "postal_code": "121974209",
            "telephone_number": "607-287-6751"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2834 COUNTY HIGHWAY 39",
            "city": "WORCESTER",
            "state": "NY",
            "postal_code": "121974209",
            "telephone_number": "607-287-6751"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FEDOR",
        "first_name": "DIANE",
        "middle_name": "P",
        "name_prefix": "Mrs.",
        "credential": "PT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-11-28",
        "last_updated": "2023-11-28",
        "certification_date": "2023-11-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "NY",
            "license": "007102-01",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Aurelia Osborn Fox Memorial Hospital Sohc
• Taylor Decook
• Robert Garfield, DO
• Thomas John Kuettel, M.D.
• Betsy Rodgers, FNP
• Nancy Lee Roubideaux, LMSW
• Robert Scott Schreiner, M.S.W., L.C.S.W.

• Physical Medicine & Rehabilitation Physician in Worcester, NY
• Providers in Worcester, NY by specialty
• Physical Medicine & Rehabilitation Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 28, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.