Provider Demographics
NPI:1316934268
Name:KREHEL, CAROL M (DPT)
Entity type:Individual
Prefix:DR
First Name:CAROL
Middle Name:M
Last Name:KREHEL
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5156 S MAIN ST
Mailing Address - Street 2:
Mailing Address - City:MUNNSVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:13409-4058
Mailing Address - Country:US
Mailing Address - Phone:315-495-2100
Mailing Address - Fax:315-495-2100
Practice Address - Street 1:5156 S MAIN ST
Practice Address - Street 2:
Practice Address - City:MUNNSVILLE
Practice Address - State:NY
Practice Address - Zip Code:13409-4058
Practice Address - Country:US
Practice Address - Phone:315-495-2100
Practice Address - Fax:315-495-2100
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-10-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY020061225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NM9672512OtherGHI
NY0007368503OtherAETNA
NY161609585-01OtherPRISM
NM10069572OtherCDPHP
NY435882OtherMVP
NYCAA1629OtherFIRST UNITED AMERICAN LIF
NY0186634OtherUNITED HEALTHCARE
NM16-1609585-002OtherRMSCO
NY0186634OtherUNITED HEALTHCARE
NY435882OtherMVP