Provider Demographics
NPI:1053712471
Name:BUELL, JANELLE (PT, DPT)
Entity type:Individual
Prefix:MISS
First Name:JANELLE
Middle Name:
Last Name:BUELL
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19 EARL MNR
Mailing Address - Street 2:
Mailing Address - City:DEANSBORO
Mailing Address - State:NY
Mailing Address - Zip Code:13328-1101
Mailing Address - Country:US
Mailing Address - Phone:315-404-1842
Mailing Address - Fax:
Practice Address - Street 1:5275 STATE ROUTE 31
Practice Address - Street 2:
Practice Address - City:VERONA
Practice Address - State:NY
Practice Address - Zip Code:13478-2913
Practice Address - Country:US
Practice Address - Phone:315-829-2520
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-09-05
Last Update Date:2014-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY038075-1225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY038075-1OtherNEW YORK STATE LICENSE