Provider Demographics
NPI:1427322205
Name:BISH-ZIEGELHOFER, CONNIE J (PT, MS, DPT)
Entity type:Individual
Prefix:MS
First Name:CONNIE
Middle Name:J
Last Name:BISH-ZIEGELHOFER
Suffix:
Gender:F
Credentials:PT, MS, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:550 ORCHARD PARK RD
Mailing Address - Street 2:BLDG C
Mailing Address - City:WEST SENECA
Mailing Address - State:NY
Mailing Address - Zip Code:14224-2646
Mailing Address - Country:US
Mailing Address - Phone:716-677-5022
Mailing Address - Fax:716-677-2845
Practice Address - Street 1:550 ORCHARD PARK RD
Practice Address - Street 2:BLDG C
Practice Address - City:WEST SENECA
Practice Address - State:NY
Practice Address - Zip Code:14224-2646
Practice Address - Country:US
Practice Address - Phone:716-677-5022
Practice Address - Fax:716-677-2845
Is Sole Proprietor?:No
Enumeration Date:2012-02-27
Last Update Date:2016-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY010695-1225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist