Provider Demographics
NPI:1992487334
Name:GELDER, MADELINE SOPHIE (PT, DPT)
Entity type:Individual
Prefix:
First Name:MADELINE
Middle Name:SOPHIE
Last Name:GELDER
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5 SPRUCE CT
Mailing Address - Street 2:
Mailing Address - City:PITTSFORD
Mailing Address - State:NY
Mailing Address - Zip Code:14534-3923
Mailing Address - Country:US
Mailing Address - Phone:585-775-5733
Mailing Address - Fax:
Practice Address - Street 1:590 FISHERS STATION DR STE 130
Practice Address - Street 2:
Practice Address - City:VICTOR
Practice Address - State:NY
Practice Address - Zip Code:14564-9744
Practice Address - Country:US
Practice Address - Phone:585-924-7207
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-04
Last Update Date:2024-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY050741-01225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist