Provider Demographics
NPI:1316073323
Name:CARNEY, ROBERT B (PHYSICAL THERAPIST)
Entity type:Individual
Prefix:MR
First Name:ROBERT
Middle Name:B
Last Name:CARNEY
Suffix:
Gender:M
Credentials:PHYSICAL THERAPIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:32 WYNNEFIELD DR
Mailing Address - Street 2:
Mailing Address - City:SOUTH GLENS FALLS
Mailing Address - State:NY
Mailing Address - Zip Code:12803-5530
Mailing Address - Country:US
Mailing Address - Phone:518-793-5573
Mailing Address - Fax:
Practice Address - Street 1:200 SMITH DR
Practice Address - Street 2:
Practice Address - City:CORINTH
Practice Address - State:NY
Practice Address - Zip Code:12822-1341
Practice Address - Country:US
Practice Address - Phone:518-654-7680
Practice Address - Fax:518-654-7693
Is Sole Proprietor?:No
Enumeration Date:2007-02-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY003851-1225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant