Michele Dawn Buddenhagen, P.T.
Individual provider Active NPI Physical Therapist · Centereach, NY
NPI 1861645335 · NPPES record last updated Apr 10, 2012
Key facts
- NPI
- 1861645335
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapist 225100000X
- License
- 011747-1 (NY)
- Practice address
- 15 Dorn PL
Centereach, NY 11720-3018 - Phone
- (631) 235-2483
- NPI assigned
- Oct 28, 2008
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 3
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 011747 | NY | MD | Mental Health Counselor |
| 011747-1 | NY | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Evolution Home Physical Therapy, P.C. | Physical Therapist | Past |
Accepting new patients |
| Home Advantage Physical Therapy PC | Physical Therapist | Past |
Accepting new patients |
| PRN Physical, Occupational and Speech Therapy Network, PLLC | Physical Therapist | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 011747-1 | NY | Yes |
Addresses
Primary practice location
15 Dorn PL
Centereach, NY 11720-3018
Mailing address
15 Dorn PL
Centereach, NY 11720-3018
Phone (631) 235-2483
Other names
- Michele Dawn Welch
Other providers in Centereach, NY
- Paige Michelle Boyajian
- Laura Elizabeth Brady
- Danielle Brennan
- Barbara Jean Broggelwirth
- Linda Jean Brown
- Rebecca Bumb
- Gina Buonagura
- Michele Susan Butzbach
- Maria Byrne
- Dori Jo Cannella
All providers in Centereach, 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 Apr 10, 2012. 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.