MEDICARE: MRS. GERALDINE G C PFEIFFER PT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist	0067191	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1386610640
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. GERALDINE G C PFEIFFER PT

Provider Business Mailing Address
First Line	:	1 HALFMOON EXCECUTIVE PARK DR
Second Line	:
City	:	CLIFTON PARK
State	:	NY
Zip	:	12065
Country	:	US
Telephone Number	:	518-371-6777
Fax Number	:	518-383-9033

Provider Business Practice Location Address
First Line	:	1 HALFMOON EXCECUTIVE PARK DR
Second Line	:
City	:	CLIFTON PARK
State	:	NY
Zip	:	12065
Country	:	US
Telephone Number	:	518-371-6777
Fax Number	:	518-383-9033

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/27/2006
Last Update Date	:	07/08/2007

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