Provider Demographics
NPI:1194871830
Name:AFFOLTER, SONDRA JAYNE (PT)
Entity type:Individual
Prefix:
First Name:SONDRA
Middle Name:JAYNE
Last Name:AFFOLTER
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5335 COUNTY ROAD 37
Mailing Address - Street 2:
Mailing Address - City:HEMLOCK
Mailing Address - State:NY
Mailing Address - Zip Code:14466
Mailing Address - Country:US
Mailing Address - Phone:603-494-5341
Mailing Address - Fax:888-310-0035
Practice Address - Street 1:50 STATE STREET
Practice Address - Street 2:
Practice Address - City:PITTSFORD
Practice Address - State:NY
Practice Address - Zip Code:14466
Practice Address - Country:US
Practice Address - Phone:603-494-5341
Practice Address - Fax:888-310-0035
Is Sole Proprietor?:No
Enumeration Date:2007-01-26
Last Update Date:2015-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH1865225100000X
NY030592-1225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist