MEDICARE: JOHN E BEARER 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	005201	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	P012005201	OTHER	NY	BCBS
2	7024316	OTHER	NY	AETNA
3	P011005201	OTHER	NY	BLUE CHOICE
4	10076FT	OTHER	NY	PREFERRED CARE

General Provider Information

NPI Number	:	1477525582
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOHN E BEARER PT

Provider Business Mailing Address
First Line	:	37 N UNION STREET
Second Line	:
City	:	SPENCERPORT
State	:	NY
Zip	:	14559
Country	:	US
Telephone Number	:	585-349-2860
Fax Number	:	585-349-2995

Provider Business Practice Location Address
First Line	:	37 N UNION STREET
Second Line	:
City	:	SPENCERPORT
State	:	NY
Zip	:	14559
Country	:	US
Telephone Number	:	585-349-2860
Fax Number	:	585-349-2995

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

Provider Enumeration Date	:	02/02/2006
Last Update Date	:	08/20/2008

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Directions to “ JOHN E BEARER PT” Practice Location

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