SHANNON M BOLGER (NPI# 1124306394) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1124306394 |
| Entity Type | Individual |
| Full Name | SHANNON M BOLGER |
| Credential | PT, DPT |
| Practice Address |
3255 Brighton Henrietta Town Line Rd Suite 102 Rochester NY 14623-2806 |
| Practice Telephone | 5854272977 |
| Enumeration Date | 2011-07-21 |
| Last Update Date | 2011-07-21 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2251P0200X |
Physical Therapist Specialization: Pediatrics |
034096 | NY | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548615362 | Shannon Mary Bolger | Student in an Organized Health Care Education/Training Program | 1700 Ludwell Dr, Maple Glen, PA 19002-3027 | 2016-04-29 |
| Street Address |
3255 BRIGHTON HENRIETTA TOWN LINE RD SUITE 102 |
| City | ROCHESTER |
| State | NY |
| Zip Code | 14623-2806 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861534281 | Pediatric Physical Therapy Services, Pllc | Physical Therapist | 3255 Brighton Henrietta Town Line Rd, Suite 102, Rochester, NY 14623-2806 | 2007-02-13 |
| 1265795173 | Jessica Shane Taylor | Specialist | 3255 Brighton Henrietta Town Line Rd, Suite 102, Rochester, NY 14623-2806 | 2012-06-18 |
| 1760798987 | Apryl N Amo Jackson | Speech-Language Pathologist | 3255 Brighton Henrietta Town Line Rd, Suite 102, Rochester, NY 14623-2806 | 2010-08-25 |
| 1457599748 | Ashley Bess Williams | Physical Therapist | 3255 Brighton Henrietta Town Line Rd, Suite 102, Rochester, NY 14623-2806 | 2009-01-26 |
| 1265670475 | Kelly Eleanor O'mara | Physical Therapist | 3255 Brighton Henrietta Town Line Rd, Suite 102, Rochester, NY 14623-2806 | 2009-01-26 |
| 1326204876 | Michelle French | Physical Therapist | 3255 Brighton Henrietta Town Line Rd, Suite 102, Rochester, NY 14623-2806 | 2008-08-04 |
| 1609094820 | Heather M Hofmann | Speech-Language Pathologist | 3255 Brighton Henrietta Town Line Rd, Suite 102, Rochester, NY 14623-2806 | 2007-04-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235637141 | Cornerstone Dental of Henrietta | Dentist | 2104 E. Henrietta Road, Rochester, NY 14623 | 2018-01-25 |
| 1770019713 | Brenna Cavanaugh | Psychologist | 200 East River Rd., Rochester, NY 14623 | 2017-05-11 |
| 1932649522 | Annette F. Cranker | Registered Nurse | 100 Groton Parkway, Rochester, NY 14623 | 2017-03-01 |
| 1588049258 | Lisa Parnell | Nurse Practitioner | 200 East River Road, Rochester, NY 14623 | 2015-07-23 |
| 1811371610 | Deanna Phoenix | Pharmacist | Elm & Carlton Streets, Main Hospital, Roswell Park Cancer Institute, Buffalo, NY 14623 | 2015-07-13 |
| 1518340801 | Erin Wong | Counselor | 945 E. Henrietta Rd, Suite 7a, Rochester, NY 14623 | 2015-07-04 |
| 1427437490 | Sarah Beren | Counselor | 115 Metro Park, Rochester, NY 14623 | 2015-05-23 |
| 1346628930 | Bohdan Klymochko | Family Medicine | 1300 Jefferson Rd Ste 100, Rochester, NY 14623 | 2015-05-14 |
| 1306242763 | Rochester Institute of Technology | Psychiatric Unit | 1 Lomb Memorial Drive, Rochester, NY 14623 | 2014-11-13 |
| 1972904423 | Jonathan Bloom | Urology | 400 White Spruce Blvd Ste B, Rochester, NY 14623 | 2014-09-15 |
| Find all providers in zip 14623 | ||||
| Taxonomy Code | 2251P0200X |
| Grouping | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Classification | Physical Therapist |
| Specialization | Pediatrics |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063781219 | Andrea Silvana Escos | Physical Therapist | 173 Martin Street, Rochester, NY 14605 | 2011-12-16 |
| 1619121985 | Susan L Murphy | Physical Therapist | 20 Newport Rd, Rochester, NY 14622-3012 | 2008-11-12 |
| 1508923095 | Rosalind Gramling | Physical Therapist | 2643 Elmwood Ave, Tcms, Rochester, NY 14618 | 2007-01-03 |
| 1417926288 | Michael Paul Amy | Physical Therapist | 131 W Broad St, Rochester City School District, Rochester, NY 14614-1103 | 2006-03-15 |
| 1235607151 | Jordyn Mary Vanelli | Physical Therapist | 1000 Elmwood Ave Ste 100, Rochester, NY 14620-3093 | 2018-11-08 |
| 1497904791 | Adrien W Reidy | Physical Therapist | 100 Groton Pkwy, Rochester, NY 14623-4540 | 2008-09-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063021335 | Margaret E O'neil | Physical Therapist | 180 Fort Washington St, Harkness 1-164, New York, NY 10032 | 2020-07-23 |
| 1295398279 | Developmental Steps, LLC | Physical Therapist | 388 Westchester Ave Ste 1a-1b, Port Chester, NY 10573-3650 | 2019-04-16 |
| 1982176079 | Abilities Center, Pllc | Physical Therapist | 10 Mountain Ledge, Wilton, NY 12831-2539 | 2018-12-30 |
| 1922575026 | Hallie Rebecca Stock | Physical Therapist | 74 Stuyvesant Ave, Larchmont, NY 10538-2730 | 2018-10-26 |
| 1508331281 | Jaya Rachwani Parshotam | Physical Therapist | 323 W 96th St Apt 509, New York, NY 10025-6279 | 2018-10-09 |
| 1730663931 | Monica Isabel Bhardwaj | Physical Therapist | 1044 Cove Rd, Mamaroneck, NY 10543-4308 | 2018-09-24 |
| 1952884934 | Jumping Feet Mgmt Corp. | Physical Therapist | 175 19th St Apt 501, Brooklyn, NY 11232-1026 | 2018-09-14 |
| 1467934000 | Victoria Buchanan | Physical Therapist | 199 Thorncliff Rd, Buffalo, NY 14223-1241 | 2018-08-30 |
| 1841786324 | Sunshine Rehab Pt PC | Physical Therapist | 19840 32nd Ave Apt B2, Flushing, NY 11358 | 2018-07-08 |
| 1346734472 | Dale Scalise-smith | Physical Therapist | 24 Osborn St, Stony Point, NY 10980-3651 | 2018-06-21 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.