Provider Demographics
NPI:1588143176
Name:SCIARRINO, BETHANY (DPT)
Entity type:Individual
Prefix:
First Name:BETHANY
Middle Name:
Last Name:SCIARRINO
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 1:67 TERRYLYNN DR
Mailing Address - Street 2:
Mailing Address - City:ANGOLA
Mailing Address - State:NY
Mailing Address - Zip Code:14006-1243
Mailing Address - Country:US
Mailing Address - Phone:716-829-9571
Mailing Address - Fax:
Practice Address - Street 1:9520 FREDONIA STOCKTON RD
Practice Address - Street 2:
Practice Address - City:FREDONIA
Practice Address - State:NY
Practice Address - Zip Code:14063-9518
Practice Address - Country:US
Practice Address - Phone:716-672-4371
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-14
Last Update Date:2021-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY043228225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist