Provider Demographics
NPI:1184727380
Name:SCHWENK, DANIEL J (PT)
Entity type:Individual
Prefix:
First Name:DANIEL
Middle Name:J
Last Name:SCHWENK
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:800 CARTER ST
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14621
Mailing Address - Country:US
Mailing Address - Phone:585-339-4793
Mailing Address - Fax:585-336-4845
Practice Address - Street 1:130 EMPIRE DR
Practice Address - Street 2:EMPIRE DRIVE HEALTH CENTER
Practice Address - City:WEST SENECA
Practice Address - State:NY
Practice Address - Zip Code:14224
Practice Address - Country:US
Practice Address - Phone:716-668-6352
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY012322225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00011283007OtherUNIVERA LEGACY#
NY9304085OtherIHA LEGACY#
NY0145386OtherGHI PPO LEGACY#
NY050331000070OtherFIDELIS LEGACY#
NY08494418Medicaid
NY159882FTOtherPREFERRED CARE LEGACY#
NY000623094004OtherHEALTH NOW BCBS LEGACY#
NYP00249362OtherMEDICARE RAILROAD LEGACY#
NY159882FTOtherPREFERRED CARE LEGACY#
NYRA5532Medicare ID - Type Unspecified