Individual
CHANEL NINAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DPT
Contact information
Practice address
201 W MADISON AVE, PHYSICAL THERAPY DEPARTMENT, JOHNSTOWN, NY 12095-2806
(518) 762-4548
(518) 736-1570
Mailing address
201 W MADISON AVE, PHYSICAL THERAPY DEPARTMENT, JOHNSTOWN, NY 12095-2806
(518) 762-4548
(518) 736-1570
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
038897
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00394849
—
NY
01
—
353581
MVP
NY
Enumeration date
06/22/2015
Last updated
06/22/2015
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